2010 NATIONAL REPORT (2009 data) 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) 2010 Editors Charlotte Davies*, Layla English$, Alan Lodwick*, Jim McVeigh$, Mark A. Bellis$ * United Kingdom Focal Point at the Department of Health 7th floor, Wellington House, 133 -155 Waterloo Road, London, SE1 8UG, UK $ United Kingdom Focal Point at the North West Public Health Observatory The Centre for Public Health, Liverpool John Moores University, 3rd Floor Henry Cotton Campus, 15-21 Webster Street, Liverpool, L3 2ET, UK Report submitted to the EMCDDA: 29th October 2010 UNITED KINGDOM FOCAL POINT REPORT 2010 The United Kingdom Focal Point on Drugs The United Kingdom (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. It is the national partner of the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and provides comprehensive information to the Centre on the drug situation in England, Northern Ireland, Scotland and Wales. The Focal Point 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 and implementation of its five key epidemiological indicators, the Exchange on Drug Demand Reduction Action (EDDRA) and the implementation of the Council Decision on New Psychoactive Substances. Further information about the United Kingdom Focal Point, including previous annual reports and data submitted to the EMCDDA, can be found on the Focal Point website at www.ukfocalpoint.org.uk The EMCDDA's website is www.emcdda.europa.eu The Head of the United Kingdom Focal Point on Drugs is Alan Lodwick at the Department of Health ([email protected]). The structure and content of this report The structure and content of this annual report are pre-determined by the EMCDDA to facilitate comparison with similar reports produced by the other European Focal Points. Ten chapters cover the same subjects each year, and three further chapters provide in-depth information on selected issues which change from year to year. Each of the first ten chapters begins with an Introduction. This sets the context for the remainder of the chapter, describing the main features of the topic under consideration within the United Kingdom. This may include information about the main legislative and organisational frameworks, sources of data and definitions used, the broad picture shown by the data and recent trends. The remainder of each chapter is concerned with New Developments and Trends that have not been included in previous annual reports. Generally, this covers developments that have occurred in the second half of 2009 or the first half of 2010. Relevant data that have become available during this period will also be discussed although these will often refer to earlier time periods. This report, and the reports from the other European countries, will be used in the compilation of the EMCDDA’s annual report of the drug situation in the European Union and Norway to be published in 2011. 1 UNITED KINGDOM FOCAL POINT REPORT 2010 National Contributors – Scotland, Wales and Northern Ireland Welsh Assembly Government Karen Eveleigh Department of Health, Social Services and Public Kieron Moore Safety, Northern Ireland Moira McKee Rob Phipps Scottish Government Kathleen Glazik Julie Carr Information Services Division, National Health Service, Cheryl Denny Scotland Paul McAleer Laura Wood Experts on the EMCDDA Key Epidemiological Indicators United Kingdom Drug Population prevalence Nicola Singleton Policy Commission Centre for Drug Misuse Problem prevalence Gordon Hay Research, University of Glasgow National Drug Evidence Treatment demand Michael Donmall Centre, University of Manchester International Centre for Drug-related deaths John Corkery Drug Policy, St George's, University of London Centre for Research on Infectious diseases Vivian Hope Drugs and Health Behaviour, London Other Focal Point Experts and Partners Frances Hardy, Home Office Anna Richardson Crime and supply data David Povey (Home Office), John Marais (Ministry of Justice) New Psychoactive Substances Les King 2 UNITED KINGDOM FOCAL POINT REPORT 2010 Main contributors for Individual Chapters Chapter One Charlotte Davies UK Focal Point Chapter Two Sarah Head UK Focal Point Alan Lodwick UK Focal Point Chapter Three Layla English UK Focal Point Chapter Four Layla English UK Focal Point Gordon Hay Centre for Drug Misuse Research, Glasgow University Chapter Five Charlotte Davies UK Focal Point Mike Donmall National Drug Evidence Centre, University of Manchester Chapter Six Layla English UK Focal Point John Corkery International Centre for Drug Policy, St George's, University of London Vivian Hope Centre for Research on Drugs and Health Behaviour, London School of Hygiene and Tropical Medicine Chapter Seven Layla English UK Focal Point Vivian Hope Centre for Research on Drugs and Health Behaviour, London School of Hygiene and Tropical Medicine Chapter Eight Charlotte Davies UK Focal Point Chapter Nine Charlotte Davies UK Focal Point Chapter Ten Charlotte Davies UK Focal Point Sarah Head Chapter Eleven Sarah Head UK Focal Point Jan Annan Department of Health Mark Prunty Department of Health Chapter Twelve Layla English UK Focal Point Chapter Thirteen Charlotte Davies UK Focal Point 3 UNITED KINGDOM FOCAL POINT REPORT 2010 In addition to those already mentioned thanks are extended to: John McCracken, Mark Prunty, Sara Mason, Clive Pritchard, Dave Marteau and Sherife Hasan at the Department of Health; the large number of staff who contributed to this report at the Home Office including Jacqueline Hoare, Angela Scrutton, Simon Eglington and Will Reynolds in addition to those mentioned overleaf; Neil Irving at the National Offender Management Service; representatives of SOCA; Tristan McAlpine at the Ministry of Justice; Stephanie Gerbert from the Information Centre for Health and Social Care; staff who contributed from the Scottish Government including Paul Bennett, Stuart King, Roisin Ash in addition to those mentioned overleaf; staff at the Welsh Assembly Government and Health Solutions Wales including Elizabeth Walsh and Josie Smith; Gary Maxwell from the Department of Health, Social Services and Public Safety, Northern Ireland; Robert Freel and Sinead Toner from the Northern Ireland Department of Justice; David Chater and Lisa Sargeant from the Department for Education; Neil Hodgson at DWP; Ann Gledson, Andrew Jones and Tim Millar from the National Drugs Evidence Centre; Scott Parrott of the Forensic Science Service; and Caryl Beynon, Lisa Jones, Ellie McCoy and David Seddon at the Centre for Public Health and the National Collaborating Centre for Drug Prevention at Liverpool John Moores University. 4 UNITED KINGDOM FOCAL POINT REPORT 2010 Table of Contents Page Summary 9 PART A: New Developments and trends 17 1. Drug policy: legislation, strategies and economic analysis………………………………. 18 1.1 Introduction 18 1.2 Legal framework 19 1.3 National action plan, strategy, evaluation and coordination 21 1.4 Economic analysis 26 2. Drug use in the general population and specific groups………………………………….. 30 2.1 Introduction 30 2.2 Drug use in the general population 31 2.3 Drug use amongst young adults 38 2.4 Drug use in the school and youth population 41 2.5 Drug use amongst specific groups in the adult population 45 2.6 Drug use amongst specific groups in the school age population 49 2.7 Attitude surveys on the use of illegal drugs 49 2.8 Emerging trends in the use of psychoactive substances 50 3. Prevention…………………………………………………………………………………………... 53 3.1 Introduction 53 3.2 Universal prevention 54 3.3 Selective prevention in at-risks groups and settings 59 3.4 Indicated prevention 60 3.5 National and local Media campaigns 60 4. Problem Drug Use…………………………………………………………………………………. 63 4.1 Introduction 63 4.2 Prevalence estimates of problem drug use 63 4.3 Data on PDUs from non-treatment sources 66 4.4 Relationship between indicators 67 5. Drug-related treatment: treatment demand and treatment availability………………….. 69 5.1 Introduction 69 5.2 Strategy and policy 70 5.3 Treatment systems 71 5.4 Characteristics of treated clients (TDI) 80 5.5 Trends of clients in treatment 88 6. Health correlates and consequences………………………………………………………….. 91 6.1 Introduction 91 6.2 Drug-related infectious diseases 92 6.3 Other drug-related health correlates and consequences 97 6.4 Drug-related deaths and mortality of drug users 106 7. Responses to health correlates and consequences………………………………………... 112 7.1 Introduction 112 7.2 Prevention of drug related emergencies and reduction of drug-related deaths 113 7.3 Prevention and treatment of drug-related infectious diseases 115 7.4 Responses to other health correlates amongst drug users 120 8. Social correlates and social reintegration……………………………………………………. 121 8.1 Introduction 121 8.2 Social exclusion and drug use 121 8.3 Social reintegration 124 9. Drug-related crime, prevention of drug related crime and, prison……………………….. 129 9.1 Introduction 129 9.2