One in a regular series of slide sets on interesting data about alcohol and other drugs (and the wider issues to do with multiple needs) from a UK perspective.

1. Interesting things about
alcohol and other drugs
March 2017
ANDREW BROWN
@ANDREWBROWN365

2. Numbers of adults receiving treatment for drug and alcohol use disorders in
prisons and other secure settings in England in 2015-16
29,146
10,259
12,298
8,551
0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
Opiate Non-opiate only Non-opiate and alcohol Alcohol only
Source: Adults and young people in secure settings in England: data for 2015-16 (PHE, 2017)
In all, 60,254 adults were in contact with
drug and alcohol treatment services
within secure settings during 2015-16,
and most (56,803) of these were within
a prison setting, with 3,124 within YOIs
and 327 within IRCs [Immigration
Removal Centres]. Just under half (48%)
of those in contact with treatment in
adult settings presented with
problematic use of opiates, a further
37% presented with problems with
other drugs (non-opiates) and 14%
presented with alcohol as their only
problem substance.

3. Proportion of the population supporting or opposing more treatment for
dependent drinkers in England and Scotland
4%
5%
14%
43%
33%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
Strongly Oppose Oppose Neither Support Strongly support
Focus group findings:
“Participants were more divided on increased funding for
treatment services for dependent drinkers. Some felt it was
a good idea, ‘I think if someone has got a problem then
help’ (E4), but there was also a perception that services
were often a waste of public resources and money, with
those receiving treatment frequently relapsing. Underlying
some of these comments was a feeling that it was the
individual who was to blame for their problem; ‘I know
people say that it’s an illness, but they get themselves into
that state in the first place’ (S3), as well as concern over
where the additional funding would come from. This lack
of consensus contrasts with the more favourable support
within the survey and indicates that though some may
believe treatment in principle is beneficial, others may be
unconvinced of its overall effectiveness and less
sympathetic towards dependent drinkers.”
Li, Jessica, et al. "Public attitudes towards alcohol control policies in Scotland and England: Results from a mixed-methods study." Social Science & Medicine (2017).

4. It is estimated that the following proportion of a GP’s practice (with 2,000
patients) will have…
17.6%
0.4%
6.0% 6.0%
3.0%
8.8%
0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
20%
Common mental health
problems
Psychosis Below diagnositic
threshold for psychosis
Alcohol dependency Drug dependency Personality disorder
Source: Mental health in the West Midlands Combined Authority (Centre for Mental Health and University of Birmingham 2017)

5. Annual public spending for those with three severe and multiple disadvantage
profiles, per person 2016-17 prices
£1,916
£6,047
£1,957
£1,235
£5,075
£3,108
£325
£3,108
£-
£1,000
£2,000
£3,000
£4,000
£5,000
£6,000
£7,000
Physical health Criminal justice Mental health Prison Rough sleeping Hostels Benefits Substance use
treatment
Source: Faulty by design. The state of public-service commissioning (Reform, 2017)

6. Proportion of rough sleepers with an assessed need for alcohol, drugs, and/or
mental health support in London
42%
33%
46%
28%
48%
39%
48%
19%
0%
10%
20%
30%
40%
50%
60%
Alcohol Drugs Mental health No alcohol, drugs or mental health
support needs
Q1 2014/15 Q2 2014/15 Q3 2014/15 Q4 2014/15 Q1 2015/16 Q2 2015/16 Q3 2015/16 Q4 2015/16 Q1 2016/17 Q2 2016/17 Q3 2016/17
Source: Combined Homelessness and Information Network (CHAIN) quarterly reports (GLA)

7. Rough Sleeping Statistics Autumn 2016, England
-
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
4,500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England Rough sleeping counts and
estimates are single night
snapshots of the number of
people sleeping rough in local
authority areas. Local authorities
decide whether to carry out a
count or an estimate. They are
encouraged to gain intelligence
for street counts and estimates
from local agencies such as
outreach workers, the police,
the voluntary sector and faith
groups who have contact with
rough sleepers on the street
Source: Rough sleeping in England: autumn 2016 (DCLG, 2017)

8. Positive drug tests carried out by Liverpool police on arrest, by drug type (2014-
15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine & opiates
The number of attempted drug tests conducted in Liverpool’s
custody suites halved between 2014-15 and 2015-16, while the
number of individuals testing positive decreased by around two-
fifths (41%). The rationale for targeted testing was to reduce the
number of negative tests in order to reduce police time. Although
the positive drug test rate has increased, it is only by a small
proportion (6%). There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of drug
using offenders coming into treatment. This is where there is
considerable concern by treatment services, commissioners and the
Police themselves. This concern is greater still for opiate drug users
in Liverpool who are not coming into the treatment system.
Source: Criminal Justice Project: Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI, 2017)

9. Number of arrest occasions for high end offenders who were arrested and tested
five or more times in 2014- 15, and arrested and tested again in 2015-16
15
11
3
9
5
3
1
2
-
2
4
6
8
10
12
14
16
One Two Three Four Five Six Seven Eight
High end offenders (those who presented five or more
times) in the May 2014 to April 2015 cohort were
matched to successful drug tests across all of
Merseyside between May 2015 and April 2016. Of the
59 offenders arrested and tested five times or more in
the May 2014 to April 2015 cohort, 49 were tested in
Merseyside between May 2015 and April 2016 (83%).
Just under seven in ten (69%) of these offenders
presented more than once (n=34), with 11 offenders
arrested five times or more. Figures suggest the
majority of high end offenders arrested and tested
under the Test on Arrest scheme during 2014-15 are
being tested through targeted testing, and their
number of arrest occasions are reducing.
Source: Criminal Justice Project: Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI, 2017)

10. Proportion of violent crime that is perceived by victims to be alcohol-related,
combined data from 2013/2014, 2014/15 and 2015/16 CSEW
0%
10%
20%
30%
40%
50%
60%
Morning Afternoon During early
evening
(6pm - 10pm)
During late
evening (10pm
-midnight)
During night
(midnight -
6am)
Time of day
Source: Appendix Tables - focus on violent crime and sexual offences (ONS 2017)
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Around the
home
Around work Street Pub or club Other location
Location

11. Number of homicides in licensed premises
52
35 35
27
21
31
19
23
27
0
10
20
30
40
50
60
2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Source: Appendix Tables - focus on violent crime and sexual offences (ONS 2017)

12. Age-standardised rates of alcohol-related deaths for males, by region
0.0
5.0
10.0
15.0
20.0
25.0
30.0
North
East
North
West
West
Midlands
East
Midlands
Yorkshire
and The
Humber
London South
West
South
East
East of
England
1995 2005 2015 With the exception of London, alcohol-
related death rates have increased in
regions of England since the mid-1990s
and have tended to be higher in the
north of England relative to the south of
England. Since the mid-2000s, the
alcohol-related death rate has declined
in London, which now has one of the
lowest alcohol-related death rates,
whereas the rate has remained
comparatively high in the north of
England.
Source: Alcohol-related deaths in the UK: registered in 2015 (ONS, 2017)

13. Prevalence of self-reported non-prescription medicine (NPM) misuse in a UK
population
4.6%
13.9%
77.1%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Yes - past month Yes - more than a month
ago
No - never
n = 393 The lifetime prevalence of any type of
self-reported NPM misuse was 19.3% (n =
76): 11.9% (n = 47) for using a higher dose
than recommended, 10.6% (n = 42) for
using more often than recommended and
10.6% (n = 42) for using for a longer time
than recommended.
Analgesics, with and without codeine,
were the most frequently misused
products.
Niamh A. Fingleton, Margaret C. Watson, Eilidh M. Duncan, Catriona Matheson; Non-prescription medicine misuse, abuse and dependence: a cross-sectional survey of the UK general population. J Public
Health (Oxf) 2017; 38 (4): 722-730. doi: 10.1093/pubmed/fdv204

14. Does taking drugs (or NPS) predict misuse of non-prescription medicine
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Used drugs or 'legal highs' Never used drugs / 'legal highs'
Ever misused or abused NCM Never misused or abused NCM
Niamh A. Fingleton, Margaret C. Watson, Eilidh M. Duncan, Catriona Matheson; Non-prescription medicine misuse, abuse and dependence: a cross-sectional survey of the UK general population. J Public
Health (Oxf) 2017; 38 (4): 722-730. doi: 10.1093/pubmed/fdv204

15. Years of life lost due to alcohol-related conditions – rate per 100,000
0
100
200
300
400
500
600
700
800
900
1000
2008 2009 2010 2011 2012 2013 2014 2015
Persons Male Female In 2015 there were an estimated
294,000 years of life lost in England
up to the age of 75 ( a rate of 552.3
years lost per 100,000 population).
The rate of years of life lost fell by
1.3% in the latest year and has fallen
most years since the beginning of
the time series (2008). Again the
rate for men (797.1 years lost per
100,000 population) is more than
double the rate for women (311.3
years lost per 100,000 population).
Source: Local Alcohol Profile for England

16. Rate of alcohol-related mortality by gender and deprivation decile, England, 2015
0
10
20
30
40
50
60
70
80
90
1 - most 2 3 4 5 6 7 8 9 10 - least
Female Male Persons
The alcohol-related
mortality rate for the most
deprived 10% of the
population was 56.2 per
100,000 population, which is
significantly higher than that
of the least deprived 10% of
the population (35.2 per
100,000 population).
Source: Local Alcohol Profile for England

17. Numbers of adults in secure settings (prisons, Youth Offending Institutions, and
Immigration Removal Centres) in England being treated for use of NPS by type
0 500 1,000 1,500 2,000 2,500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedative/opioid
Predominantly dissociative
Six percent of all adults in
treatment cited New
Psychoactive Substances
(NPS) as one of their problem
substances, or their only
problem substance. This
figure represents the number
of adults presenting for
treatment with problem NPS
use and not necessarily a
reflection of overall NPS
prevalence in adult secure
settings.
Source: Adults and young people in secure settings in England: data for 2015-16 (PHE, 2017)

18. Substance use of all young people in treatment in secure settings, in England in
2015-16
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
Crack
There were 1,541 young people in specialist
substance misuse treatment in a secure
setting in 2015-16. The majority (69%) of
young people in treatment in secure settings
reside in YOIs, with a further 16% residing in
Secure Children’s Homes (SCHs), 12% in
Secure Training Centres (STCs) and 3% in
Welfare Only Homes (WOHs).
Cannabis was the most commonly cited
problem substance amongst young people in
treatment in secure settings (91% of all in
treatment). Around half cited problematic
alcohol use (51%). Other substances reported
by young people included nicotine (19%),
cocaine (19%), amphetamines (9%), ecstasy
(8%) and NPS (8%). Two percent of young
people cited problematic opiate use.
n = 1,541
Source: Adults and young people in secure settings in England: data for 2015-16 (PHE, 2017)

19. Vulnerabilities of young people in treatment for substance use in secure settings
in England in 2015-16
0% 10% 20% 30% 40% 50% 60% 70% 80%
Poly substance use
High risk alcohol user
Pregnant / parent
Injecting - currently or previously
Opiate and/or crack use
n = 1,172
Young people in custody report a
disproportionately higher level of
substance misuse than in the young
population in general3 and substance
misuse is a factor that may exacerbate
the additional vulnerabilities
experienced by children and young
people within the secure estate.
The majority reported poly substance
use (72%). Lower proportions reported
high-risk alcohol use (4%), pregnant /
parent (3%), current or previous
injecting (2%), and opiate and/or crack
use (2%). Two or more vulnerabilities
were identified in 9% of young people
starting treatment.
Source: Adults and young people in secure settings in England: data for 2015-16 (PHE, 2017)

20. The 20 local authorities with the highest rate of rough sleeping per 1,000
households in England
0
2
4
6
8
10
12
Source: Rough sleeping in England: autumn 2016 (DCLG, 2017)

21. Population mean consumption (units per week) as measured by General Lifestyle
Survey of Great Britain
0
1
2
3
4
5
6
7
8
1978 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010
Beer Wine Fortified wine Spirit
Robin C. Purshouse, Alan Brennan, Daniel Moyo, James Nicholls, Paul Norman; Typology and Dynamics of Heavier Drinking Styles in Great Britain: 1978–2010. Alcohol and Alcoholism 2017 1-10. doi:
10.1093/alcalc/agw105

22. Prevalence of heavier drinking as measured by General Lifestyle Survey of Great
Britain
13% 13% 13% 13% 14% 14% 14% 15% 16% 16% 17% 18% 18%
16%
20%
18% 18%
5% 5% 4% 4%
4% 4% 4% 4%
4%
4% 4%
5% 5%
4%
7%
6%
5%
0%
5%
10%
15%
20%
25%
30%
1978 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010
Increasing risk (%) Higher risk (%)
‘Increasing risk’ (>21–50
units per week for males;
>14–35 units per week for
females) and ‘higher risk’
(>50 units per week for
males; >35 units per week
for females) levels are
defined according to the
weekly equivalent UK
Government guidelines
on safe drinking levels
1987–2016.
Robin C. Purshouse, Alan Brennan, Daniel Moyo, James Nicholls, Paul Norman; Typology and Dynamics of Heavier Drinking Styles in Great Britain: 1978–2010. Alcohol and Alcoholism 2017 1-10. doi:
10.1093/alcalc/agw105

23. Proportion of patients treated in general hospitals with serious mental illness
identified as having coexisting drug and alcohol misuse problems
15%
12%
8%
26%
17%
11% 11%
30%
0%
5%
10%
15%
20%
25%
30%
35%
Schizophrenia Other
psychosis
Bipolar
affective
disorder
Personality
disorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source: Mental Health in General Hospitals: Treat as One (NCEPOD, 2017)

24. Estimated tax gap (£ million) caused by the illicit sale of beer in the UK
£0
£200
£400
£600
£800
£1,000
£1,200
£1,400
£1,600
2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 2013-14 2014-15
Millions
Upper estimate
Implied central estimate
Lower estimate
“The beer illicit market share was estimated
at 15% in 2014-15. This resulted in estimated
losses of £650 million in duty and a further
£300 million in Value Added Tax (VAT) giving
a total loss of £950 million.
“The illicit market share in beer has
increased from 9% in 2007-08 to 15% in
2014-15.
“HMRC uses two different methods to
estimate the beer tax gap. These methods
provide an upper estimate and lower
estimate. The true tax gap could be
anywhere between these two estimates. The
implied central estimate is intended to be an
indicator of long-term trends.”
Source: Measuring tax gaps 2016 edition (HMRC, 2016)

25. Estimated tax gap (£ million) caused by the illicit sale of spirits in the UK
£0
£200
£400
£600
£800
£1,000
£1,200
£1,400
2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 2013-14 2014-15
Millions
Upper estimate
Implied central estimate
Lower estimate
The estimated illicit market share
for spirits was 12% in 2014-15,
with a total tax gap of £650
million. This is broken down into
a loss of £240 million in VAT and
£410 million in duty.
The estimates of the spirits tax
gap are quite volatile. The
confidence intervals for the
spirits tax gap are wide and year-
on-year changes should be
interpreted in the context of this
statistical uncertainty.
Source: Measuring tax gaps 2016 edition (HMRC, 2016)

26. Estimated tax gap (£ million) caused by the illicit sale of wine in the UK
£0
£200
£400
£600
£800
£1,000
£1,200
2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 2013-14 2014-15
Millions
Upper estimate Central estimate Lower estimate
It has not been possible to estimate the
illicit market share for wine, due to a
change in one of the underlying
commercial data sources previously
used to estimate the wine tax gap. An
illustrative estimate of 3% is provided
for 2013-14 and 2014-15 by taking the
average illicit market share of 2011-12
and 2012-13. This would indicate a
total wine tax gap of around £200
million in 2013-14 and 2014-15. HMRC
is exploring alternative data sources in
order to develop a new method to
estimate the wine tax gap in the future.
Source: Measuring tax gaps 2016 edition (HMRC, 2016)