Country overview: United Kingdom
- Drug use among the general population and young people
- Problem drug use
- Treatment demand
- Drug-related infectious diseases
- Drug-related deaths
- 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 (27 countries)||Source|
|Population||2012||62 989 551 p||503 663 601 b p||Eurostat|
|Population by age classes||15–24||2012||13.0 % p||11.7 % b p||Eurostat|
|25–49||34.4 % p||35.4 % b p|
|50–64||18.2 % p||19.5 % b p|
|GDP per capita in PPS (Purchasing Power Standards) 1||2011||109||100||Eurostat|
|Total expenditure on social protection (% of GDP) 2||2010||28.0 %||29.4 % p||Eurostat|
|Unemployment rate 3||2012||7.9 %||10.5 %||Eurostat|
|Unemployment rate of population aged under 25 years||2012||21.0 %||22.8 %||Eurostat|
|Prison population rate (per 100 000 of national population) 4||2011||
94.3 (Northern Ireland)
152.0 (England and Wales)
|:||Council of Europe, SPACE I-2011|
|At risk of poverty rate 5||2011||16.2 %||16.9 % 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, 2011.
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 2002. 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 2008/09 (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 2011/12 CSEW, conducted among people aged 16–59, showed that 36.5 % of respondents had tried any illicit drug at least once in their lives (lifetime prevalence rates). Lifetime prevalence of cannabis was 31 %; amphetamines 11.5 %; cocaine 9.6 %; ecstasy 8.6 %; and LSD 5.3 %. In 2011/12 last year prevalence of cannabis use was reported to be 6.9 %, showing a steady decline in cannabis use since 2003/04 (10.8 %) and stabilisation since 2009/10. Last month prevalence of cannabis was reported by 4.1 % of respondents. Current cannabis use was more prevalent among 16- to 24-year-olds than among older respondents. However, the older respondents who continued cannabis use more frequently reported daily or almost daily use of the substance. 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. A decrease in amphetamine use is observed since 2003. In the 2011/12 CSEW 1.1 % of respondents reported use of mephedrone in the last 12 months, a decrease from 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.
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. Lower prevalence (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 %.
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 2011. 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 16.8 % in 2011, last year prevalence was 11.8 % and last month prevalence was 6.0 %.
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 21 % in 2011, which is further validated by data from the latest HBSC study, which reported that 19 % of respondents had ever used cannabis. The latest HBSC results for 2010 also indicate a decline in lifetime cannabis prevalence rates among 15-year-olds from 36 % in 1998 to 22 % in Wales, and from 37 % in 2002 to 19 % in Scotland.
Preventing drug use among young people is a key element of drug strategies in the United Kingdom. Establishing a whole-life approach to drug prevention covering early years, family support, drug education and targeted, specialist support is a main aim of the UK 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, and most schools have a drug education policy and guidelines on dealing with drug incidents. Often, drug prevention is delivered within the wider health and social education agenda and addresses both licit and illicit substances. 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. 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, 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.
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.
Communication programmes such as Talk to FRANK in England, Know the Score[http://knowthescore.info] in Scotland and DAN 24/7[dan247.org.uk] in Wales provide information and advice to young people and their families.
View ‘Prevention profile’ for additional information.
Problem drug use estimates are available for England, Northern Ireland, Scotland and Wales at the national, regional and local level (including 149 Drug Action Team areas in England). Estimates are mostly obtained through the capture–recapture and/or multiple indicator method, as is appropriate for the data concerned.
Latest estimates for the United Kingdom suggest that there are 383 534 problem drug users (95 % CI: 372 560– 406 408), which is a rate of 9.4 (9.1–9.9) per 1 000 population. This estimate is based on different definitions of problem drug use and different time periods. In England (2009/10) case definition is the use of opiates and crack cocaine; in Scotland it is the use of opiates and/or the illicit use of benzodiazepines (2009/10), and a drug injecting estimate is available for 2006; in Northern Ireland (2004) it is opiate and/or problem cocaine powder use; and in Wales (2009/10) it is long duration or regular use of opiates, cocaine powder and/or crack cocaine.
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. Details are available here.
Treatment demand data for the United Kingdom are collected from outpatient (1 501) and inpatient (140) treatment centres, and general practitioners (173, all in England). In 2010/11 a total of 119 652 clients entered treatment, of which 47 566 were admitted to the 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 2010/11.
In 2010/11 opiates were the most reported primary drug among all treatment clients at 59.3 %, followed by cannabis at 20.3 % and cocaine at 12.3 %. Among new treatment clients the primary substance of use was opiates at 40.0 %, followed by cannabis at 32.4 % and cocaine at 16.0 %. (1)
In 2010/11 some 37 % of all treatment clients were over the age of 35, compared to 30 % of new treatment clients. 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 2010/11 some 7.4 % of all treatment clients and 11.4 % of new treatment clients indicated their primary substance of use was cocaine powder, while 4.8 % of all treatment clients and 4.6 % of new treatment clients indicated crack cocaine as their primary substance.
Data on the prevalence of blood-borne infectious diseases among injecting drug users (IDUs) 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 IDUs attending drug services in England, Wales and Northern Ireland. The Centre for Research on Drugs and Health Behaviour has conducted surveys of IDUs recruited in community settings, and the Scottish Centre for Infection and Environmental Health (SCIEH) surveys the prevalence of blood-borne infections among IDUs attending drug services in Glasgow. SCIEH also holds anonymised epidemiological data on everyone who has had a named 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 2011 there were 131 HIV diagnoses where infection was thought to have been acquired through injecting drug use. HIV prevalence remains low in the United Kingdom, although prevalence amongst recent initiates has been elevated since 2003. In England and Wales, of those participating in the 2011 UAM survey, HIV prevalence was 1.3 %, while HIV prevalence among tested IDUs in Northern Ireland and Scotland was lower, at 0.6 % and 0.3 % respectively. In 2011 some 1 636 HIV-infected IDUs were seen for HIV-related treatment or care in the United Kingdom. About 87 % of people who were HIV positive and had been recommended to start antiretroviral treatment received it.
In 2011 the prevalence of antibodies to the hepatitis C virus (HCV) among IDUs in England and Wales was 44.5 %. In Northern Ireland prevalence was 28.7 %, while estimated HCV prevalence among clients of the Scottish Needle Exchange Surveillance initiative was 53.2 %, which is similar to 2008/09 data. The prevalence varies not only according to region, but also to other risk factors such as duration of injecting. There has also been evidence of increased incidence, especially among new injectors.
Prevalence of hepatitis B virus (HBV) antibodies among IDUs has steadily declined since the early 2000s, and in 2011 the rate varied by country between 10 % and 16 %, the lowest being for Northern Ireland and the highest for England and Wales. The decline is partly attributed to increased uptake of the hepatitis B vaccine among injecting drug users during the past decade.
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 illegal drug; while the Drug Misuse Definition developed for the UK Drug Strategy measures death cases where the underlying cause is drug abuse, drug dependence or poisoning where any of the 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-related deaths in the United Kingdom rose steadily from 1996 to 2001, fell from 2001 to 2003, increased to 2 231 in 2008, and fell to 1 930 in 2010. In 2011 the number of deaths continued a downward trend to 1 785. Based on the Drug Misuse Definition, the number of drug-related 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 2011 to 2 250. Opiates were mentioned on the death certificate in around 86 % of these death cases. Males accounted for 73.9 % of deaths and the average age at death was 40.8 years.
All UK 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 and recovery. Delivery of drug treatment is through local multi-agency partnerships representing health, criminal justice agencies and social care services. In recent years increased attention has been given 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, needle and syringe programmes, psychosocial and pharmacological treatment, detoxification and residential rehabilitation. 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 provides a new national framework for best practice for practitioners and effectively updates and replaces the Models of Care document and the previous four-tiered treatment framework in England.
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. Since April 2013 this programme is no longer centrally funded and it is up to local areas to 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.
Substitution treatment 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 (51 % methadone, 47 % buprenorphine and 2 % dihydrocodeine); 22 224 received methadone treatment in Scotland in 2006/07; 153 033 receiving a prescribing intervention in England; and 2 129 receiving substitution treatment in Wales in 2010/11.
View ‘Treatment profile’ for additional information.
Reduction of drug-related 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, as well as 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, provision of take-home naloxone and training of drug users and their family members on its application.
In 2009–10 the United Kingdom experienced an anthrax outbreak among heroin users. As a result, a dedicated web page providing epidemiological updates and guidance for professionals (clinicians, drug workers, etc.) was established, and anthrax anti-toxin was distributed among health practitioners to complement classical treatment protocols for those affected. In 2012 one anthrax case in Scotland was confirmed, which was followed up by further dissemination of information to drug users and drug workers.
Syringe exchange is offered by a wide range of services, including specialist syringe exchange services, detached outreach and mobile units, pharmacies and accident and emergency services. Services are available across all regions in the United Kingdom, but data on syringes distributed in England are not available. Latest available estimates are 5 140 000 for Wales; 197 000 for Northern Ireland in 2011/12; and 4 506 000 for Scotland in 2010/11. 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. UK 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. However, the government has not yet passed this into law.
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 drugs 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.
Almost all the heroin in the United Kingdom originates from Afghan opium. During 2011 a significant amount of the heroin seized at the borders had been trafficked directly from Pakistan via parcels, air freight, air courier or maritime containers. Heroin trafficked via Pakistan is also sent by sea on to eastern and southern Africa and moved on to western Europe or through Pakistani Baluchistan into Iran and Turkey, although there has been a continued reduction in the supply of heroin smuggled via Turkey. The majority of the United Kingdom’s identified cocaine supply is produced in Colombia, although United Nations production figures suggest that Peru and Bolivia are becoming more important in this regard. Cocaine arrives in Europe mainly via the Iberian Peninsula and the Netherlands/Belgium. Substantial quantities of cannabis resin and herbal cannabis continue to be imported into the United Kingdom. Morocco is the primary source of cannabis resin for the UK market. The main routes for transhipment are by road through the Iberian Peninsula, France, Belgium and the Netherlands. In addition, cannabis cultivation operations have been increasingly discovered in the past five years. While in many instances these are large commercial cultivation sites, there is an increasing recent trend towards smaller operations carried out in multiple locations. 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 countries of origin being China and India for the majority of these substances. Ketamine, originating from India, mainly enters through mail, parcel services or, recently, by sea and is increasingly diverted to the UK illicit market.
In 2011 there were 152 406 convictions or cautions for drug offences reported by the United Kingdom, which is an increase when compared to 2009 (147 013), and a similar level to 2010 (152 451). Of those offences where a drug was known, 60.9 % were cannabis-related, 15.3 % cocaine-related and 9.8 % heroin-related. In addition, there were 95 934 formal warnings for cannabis or penalty notices for disorder issued for cannabis possession.
In general, the quantity of seizures has been decreasing, with cannabis being the most seized drug. In 2011, (2) some 19 473 kg of cannabis resin, 22 000 kg of herbal cannabis and 612 373 cannabis plants were seized across the United Kingdom. After 2008, (2) when a record number of 24 659 cocaine seizures were reported, a steady decrease in cocaine seizures was noted. The quantity of seized cocaine has been on the decline since 2003 (2) when 7 773 kg of cocaine was seized. In 2011 some 3 456 kg of cocaine was seized. (2) In recent years the number of heroin seizures has been declining, with the lowest number of heroin seizures (9 150) reported in 2011. In 2010 (2) the quantity of heroin seized was the lowest amount since 1995 (832 kg), but in 2011 the quantity seized increased to 1 849 kg. Following a decline in the number of ecstasy tablets seized since 2006, the figure almost doubled in 2011 in comparison to 2010, although it remains well below 2006 levels. (2) The quantity of amphetamines seized in 2011 slightly increased when compared to 2010 (1 042 kg and 983 kg respectively). (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 and data reported in 2011 is for 2011/12).
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 Magistrate 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 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. In 2012 methoxetamine became the first drug subjected to a temporary class drug order in the United Kingdom.
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 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 UK 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 drugs strategy, the UK 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 UK 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 2010 Strategy is a cross-government strategy, although secretariat and programme management responsibilities fall to the Home Office. Overall, the 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 the 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 co-terminous 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 service.
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.
Under the United Kingdom’s drug strategies there are no budgets. Budget allocations are provided annually to entities in charge of providing services. Authorities have funded two studies on economic and social costs, in 2002 and 2006. (3) Labelled expenditures are estimated every year in the United Kingdom through administrative records, but unlabelled expenditures are only seldom 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 % for 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. Within labelled expenditures it was different: 64.5 % for health, 28.4 % for public order and safety, 6.0 % for general public services, 1.0 % for social protection and 0.1 % for education.
Trend analysis shows that between 2005 and 2010 labelled expenditures remained broadly stable in 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.
Drug-related public expenditure is foreseen to become more difficult to estimate in the future 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 preventive early 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.
(4) 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.
(5) 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 2012 UK National report include all areas of research but mainly focused on aspects related to the consequences of drug use and responses to the drug situation. Research on drug use prevalence and on mechanisms of drug use and effects was also widely available.
View ‘Drug-related research’ for additional information.