Posted on: 19 December, 2024

This month, the government released figures related to the number of people in contact with providers for the treatment of alcohol and drugs, for the period between April 2023 and March 2024. Additionally, the government released data relating to the number of young people in contact with treatment providers, covering the same period of time. 

The adult figures revealed that there were 310,863 adults in contact over this period, which is an increase of 7% compared to the previous 12 months (290, 635). This represents the largest rise in adults in treatment since 2008/2009 and the highest number of people in contact with treatment since 2009/2010.  

The number of people entering treatment for the same period was 158,991, which is an increase of 19% for the year prior and 15% for the same timeframe two years before. According to the data, the figure entering treatment was relatively stable between 2016/2017 to 2021/2022. 

For young people – aged 17 and under – the total number of people in treatment was 14,352, a 16% increase on the year prior, but 41% lower than the peak of over 24,000 between 2008 and 2009. 

Data Trends 

Substance Data 

44% of people in treatment were seeking support for opiates, with 25% in treatment for other controlled substances and 30% in treatment for solely alcohol. 

Of the total, around two thirds were male and a third female (68% vs 32%) however these figures fluctuate significantly when separated by substance type.  The alcohol-only group saw a smaller disparity with males comprising  59% and females making up 41% of the treatment population of that drug group. There was an increase in the treatment population for both genders compared to the previous year.  

The second largest group by substance is for alcohol, the most widely consumed psychoactive substance, which makes up 30% of adults in treatment. 

There has been an increase in the number of adults entering treatment for ketamine, rising steadily over the past two years. 3,609 are now in treatment for ketamine, which is 8 times higher than the 426 in treatment between 2014/2015. 

Housing & People in Treatment 

Other recorded data reveals that over one in five people entering treatment had no home of their own, whilst the figure rose to nearly two in five for those entering for treatment of opiate use (39%). 

9% of people entering treatment stated they were at risk of homelessness within eight weeks of the point of assessment. This figure was once again around twice as high for those being treated for opiates and represents just under one in five (18%). For people entering treatment for alcohol use, the same figure was significantly lower at 5%, or one in twenty. 

Removing the cohort of people in treatment for alcohol only, the number of people who owned their own home was under one in ten people.  

Mental Health 

Nearly three in four entering into treatment (72%) said they had a mental health issue which is stable compared to the year prior, but a significant increase compared to 2018/2019 when the figure was just over half (53%). The interconnection between poor mental health and dependent alcohol or drug use is inextricable and highlights the need for more options to address comorbidities and issues attached to dual diagnosis. 

Leaving Treatment 

137,477 people left treatment over the period covered, with just under half ‘successfully completing treatment’, 1% higher than the year prior. Tragically, 1.3% of all adults, or 4,022 in treatment died while in contact with providers. 

Age (Adults only) 

 The treatment population is getting older, with over three in five peolple in treatment over the age of 40 and 29% of those in treatment aged over 50, which is up from just 12% in 2009/2010. 

Age (Young People) 

There were 14,352 children and young people (aged 17 and under) in alcohol and drug treatment between April 2023 and March 2024. This is a 16% increase from the previous year (12,418). However, the number in treatment is 41% lower than the peak of 24,494 in 2008 to 2009. 

Cannabis remains the most common substance for young people in treatment (87%) whilst just under 2 in 5 (39%) were in treatment for alcohol consumption. People in treatment for ketamine, and solvents including nitrous oxide, are increasing year on year. Ketamine has surpassed cocaine for the first time in terms of young people in treatment. 

Referrals 

Criminal justice referrals made up 15% of all referrals into treatment over the timeframe, with 28% of opiate referrals coming from the criminal justice system. This highlights the importance of innovatively using criminal justice encounters as a means to engage people who might benefit from treatment, whilst addressing underlying root causes issues related to crime. 

Parents Who Use Drugs 

20% or 30,865 of people starting treatment were living with children, either their own or someone else’s and a further 13% were parents who did not live with any children. Of the total figure, 27% were women, and 16% were men. There were 57,121 people living with an adult who is in treatment for alcohol and other drugs. 

Therefore, a 1/3 of the treatment population are parents and the gender disparity of those that are parents demonstrates the need for more consideration from providers in how to ensure that services are safe and non-stigmatising spaces where parenting can be addressed, discussed and supported by drug and alcohol services. This includes providing spaces for children as well as working with local social care services to ensure drug use does not define one’s parenting. 

Analysis 

According to several indicators including drug deaths per year, drug potency for several substances, and a statement from the National Crime Agency, it is currently the most dangerous time to be using controlled drugs in the United Kingdom. It is therefore encouraging that there has been an uptick in both people entering treatment and people in contact with providers, however more must be done to make treatment appealing to reach those that we still fail to reach. 

Funding announced off the back of the publication of the Ten-Year Strategy is potentially coming to an end in 2025, and providers must be given assurances that this will be ring-fenced. This is particularly important given the rise in potent, synthetic drugs contaminating the market, and it is likely that this situation could worsen if there is a shortage of long-established drugs in the UK market. 

Referrals from the criminal justice system – particularly for opiates and potentially because of acquisitive crime related to the purchase of drugs – demonstrates the validity in innovative use of the criminal justice system.  

Cranstoun advocates for a whole system approach to managing drug and alcohol use, with interventions available at every phase of the process. An evidence-based focus on education and treatment, rooted in compassionate, person-centred approach. Since 2020, Cranstoun’s DIVERT scheme has diverted over 10,000 people away from the criminal justice system and towards education, whilst Cranstoun’s Arrest Referral Scheme has referred 4,806 people to treatment since its inception. 

The large cohort of people entering treatment for opiates and receiving prescriptions (94%) – and to a lesser extent alcohol (18%) – demonstrates the evidence in substitution therapies being an essential tool for engaging and keeping people in treatment. Approaches which are proven to be effective in reducing harm for people who use drugs is essential. 

Whilst the number of people in treatment has increased, providers are still failing to reach people who might benefit from treatment. Further use of person-centred, enhanced outreach – such as Cranstoun’s Dynamic Evolving Model of Outreach (DEMO) – could improve engagement.  Cranstoun’s DEMO is predicated on an approach rooted in compassion, which meets people where they are at and aims to enable relationship building by helping people who are not yet in treatment. 

Reforms which enable providers to deliver overdose prevention services would also provide another route for providers to support people who use drugs, by meeting them where they are at geographically, physically and psychologically. Both enhanced outreach and overdose prevention services help to build meaningful relationships, understand health needs and the general needs of the person using the services. 

The data revealed that secure housing is an issue for large groups of people in treatment. Formalised roll out and adequate funding of schemes such as Housing First and low threshold supported housing is required to begin addressing this issue. Stable, secure and adequate housing is an essential need when endeavouring to reduce or halt dependent drug or alcohol use. Lastly, the disparity in housing issues for people who use controlled drugs compared to people who use alcohol demonstrates the additional challenges faced by people using drugs due to the legal ramifications associated with controlled substances. 

Conclusion 

The incremental increase in the number of people receiving treatment for substance use demonstrates that the uplift in funding from the 10 year strategy is having a positive effect. However, it is evident that more must be done to engage people into treatment by making it more appealing for people who use drugs. Interventions such as overdose prevention centres, diversion – both pre and post, and ensuring that a treatment option is available at every step of the criminal justice system. 

Recommendations 

• Tackle the sharp rise in cocaine related deaths by consulting with providers to make treatment more appealing, through harm reduction interventions which encourage trust and provide tangible help for people who want support – wherever they are at.  

• Utilisation of innovative methods to engage more people into treatment. These include Overdose Prevention Centres, access to a wider range of substitute replacement therapies including diamorphine and increased access to long acting buprenorphine. 

• Implementing a Whole System approach to ensure there is an intervention at every phase of the criminal justice system. 

• Improved service provision for women and gender diverse populations that encapsulate gendered experiences of drug and alcohol use. 

• Greater access and action for parents with/without care of children who are accessing treatment services to reduce stigma and improve responses for parents and their children as a result.  

• Funding uplift ringfenced with a real terms increase to take into account inflation and additional cost relating to Employer National Insurance Contributions. 

• Further use of enhanced outreach services, which are person centred, to better engage those who treatment are failing to reach, but are most at risk. 

• Working with people who have lived and living experience to better understand the needs of people who are not in treatment, to understand how we can better reach and support people who use drugs. 

• Improved access to mental health support within substance use services to address dual diagnosis issue. 

• More schemes that support people who use drugs to get off the street (such as Housing First). 

• Formalisation of pre-arrest diversion schemes which focus on health and education, as opposed to criminal sanctions. 

• Rapid access to treatment.