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2004 NATIONAL REPORT to the EMCDDA by the Reitox National Focal Point

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2004 NATIONAL REPORT to the EMCDDA by the Reitox National Focal Point Centre for Public Health 2004 NATIONAL REPORT TO THE EMCDDA by the Reitox National Focal Point UNITED KINGDOM New developments, Trends and in-depth information on selected issues REITOX United Kingdom Drug Situation. Annual Report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) 2004 Editors Gail Eaton*, Michela Morleo$, Alan Lodwick*, Mark A. Bellis$, Jim McVeigh$ * UK Focal Point at the Department of Health Skipton House, 80 London Road, Elephant and Castle, London, SE1 6LH, UK $ UK Focal Point at the North West Public Health Observatory The Centre for Public Health, Liverpool John Moores University, 8 Marybone, Liverpool, L3 2AP, UK National Contributors – Scotland, Wales and Northern Ireland Damian Buchanen Department of Health, Social Services and Public Safety Karen Eveleigh Welsh Assembly Government Kieron Moore Department of Health, Social Services and Public Safety Elaine Parry Information and Statistics Division, Scottish Executive Stephen Pavis Information and Statistics Division, Scottish Executive Sandra Wallace Scottish Executive Experts on the EMCDDA Key Epidemiological Indicators Population Prevalence UK Focal Point Gail Eaton Problem Prevalence Glasgow University Gordon Hay Treatment Demand Department of Health Patsy Bailey Drug-Related Deaths St George’s Hospital Medical John Corkery School Infectious Diseases Centre for Research on Vivian Hope Drugs and Health Behaviour, Imperial College, London The United Kingdom Focal Point on Drugs The UK Focal Point on Drugs is based at the Department of Health and the North West Public Health Observatory at the Centre for Public Health, Liverpool John Moores University. Along with equivalent organisations in other EU Member States, the Focal Point provides detailed information to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) on the drug situation in England, Northern Ireland, Scotland and Wales. It works closely with the Home Office, other Government Departments and the devolved administrations. In addition to this annual report, it collates an extensive range of data in the form of standard tables and responses to structured questionnaires, which are submitted regularly to the EMCDDA. It also contributes to other elements of the EMCDDA’s work such as the development of its five key epidemiological indicators, the Exchange on Drug Demand Reduction Action (EDDRA) and the implementation of the Joint Action on New Synthetic Drugs. The UK Focal Point website can be found at www.ukfocalpoint.org.uk and is currently under development. The EMCDDA website is www.emcdda.eu.int. The Head of the UK Focal Point on Drugs is Alan Lodwick at the Department of Health ([email protected]). The report largely describes the situation in 2003 and was submitted to the EMCDDA in 2004. It, and the reports from the other EU Member States, will be used in the compilation of the EMCDDA’s annual report to be published in 2005. Authors and Contributors for Individual Chapters Chapter One Home Office, Drugs Strategy Directorate Stuart Harwood, Trevor Crook Chapter Two UK Focal Point Gail Eaton Glasgow University Gordon Hay Chapter Three UK Focal Point Gail Eaton Home Office, Drugs Strategy Directorate Paul Baker Chapter Four Glasgow University Gordon Hay Chapter Five UK Focal Point Gail Eaton Chapter Six St. George’s Medical School, London John Corkery Centre for Research on Drugs and Health Vivian Hope Behaviour, Imperial College, London UK Focal Point Gail Eaton Chapter Seven St. George’s Hospital Medical School John Corkery Centre for Research on Drugs and Health Vivian Hope Behaviour, Imperial College, London Gail Eaton Chapter Eight Home Office, Drugs Strategy Directorate Robin Burgess, Julie Clouder Department for Transport Tim Norman Her Majesty’s Prison Service Martin Lee, Dave Marteau Chapter Nine Home Office, Drugs Strategy Directorate Robin Burgess, Julie Clouder Her Majesty’s Prison Service Martin Lee, Dave Marteau Home Office, Drug and Alcohol Research Katie Ashton Programme Chapter Ten Home Office, Drug and Alcohol Research Jennifer Airs, Lungowe Mwenda Programme Chapter Eleven UK Focal Point Gail Eaton Chapter Twelve Home Office, Drugs Strategy Directorate, Tracy Beswick Criminal Justice Intervention Programme Her Majesty’s Prison Service Jane Seddon Chapter Thirteen Home Office Drugs Strategy Directorate Robin Burgess Special thanks are extended to the following in the preparation of this report: Caryl Beynon and Sara Hughes, Centre for Public Health, Liverpool John Moores University; Ali Judd, Centre for Research on Drugs and Health Behaviour, Imperial College, Imperial College London; Mark Prunty and Tara Sahadeo, Department of Health; Scott Parrott, Forensic Science Service; Natalia Chivite-Matthews, Daniel Coles, Gabriel Denvir, Ziggy Macdonald, James Marmion, Home Office; Malcolm Ramsey, National Criminal Intelligence Service; Mike Donmall and Andrew Jones, National Drugs Evidence Centre. Contents SUMMARY.................................................................................................................. 7 PART A: NEW DEVELOPMENTS AND TRENDS................................15 1. National policies and context ................................................................................ 15 1.1 Overview ......................................................................................................... 15 1.2 Legal framework.............................................................................................. 16 1.3 Institutional framework, strategies and policies............................................... 18 1.4 Budget and public expenditure........................................................................ 19 1.5 Social and cultural context .............................................................................. 20 2. Drug use in the population .................................................................................... 22 2.1 Overview ......................................................................................................... 22 2.2 Drug use in the general population ................................................................. 23 2.3 Drug use in the school and youth population .................................................. 24 2.4 Drug use among specific groups..................................................................... 26 2.5 Attitudes to drugs and drug users ................................................................... 27 3. Prevention............................................................................................................. 28 3.1 Overview ......................................................................................................... 28 3.2 Universal prevention........................................................................................ 28 3.3 Selective/indicated prevention......................................................................... 31 4. Problem drug use.................................................................................................. 33 4.1 Overview ......................................................................................................... 33 4.2 Prevalence and incidence estimates............................................................... 34 4.3 Profile of clients in treatment ........................................................................... 34 4.4 Main characteristics and patterns of use from non-treatment sources............ 36 5. Drug-related treatment.......................................................................................... 37 5.1 Overview ......................................................................................................... 37 5.2 Treatment systems.......................................................................................... 38 5.3 Drug free treatment ......................................................................................... 39 5.4 Medically assisted treatment ........................................................................... 40 6. Health correlates and consequences.................................................................... 41 6.1 Overview ......................................................................................................... 41 6.2 Drug-related deaths and mortality of drug users ............................................. 43 6.3 Drug-related infectious diseases ..................................................................... 47 6.4 Psychiatric comorbidity (dual diagnosis) ......................................................... 49 6.5 Other drug-related health correlates and consequences ................................ 49 7. Responses to health correlates and consequences ............................................. 51 7.1 Overview ......................................................................................................... 51 7.2 Prevention of drug-related deaths ................................................................... 52 7.3 Prevention and treatment of drug-related infectious diseases ........................ 53 7.4 Interventions related to psychiatric comorbidity .............................................. 55 7.5 Interventions related to other health correlates and consequences................ 55 8. Social correlates and consequences .................................................................... 56 8.1 Overview ........................................................................................................
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