Drug
and alcohol misuse causes a number of social ills. It damages the health and
ruins the lives of individuals; it affects family life and contributes to crime
rates. The costs to society (and individuals) are enormous. Tackling alcohol
and drug misuse is a complex problem and requires integrated solutions and
co-ordinated delivery of services involving education, health and social care,
intelligence and enforcement and economic policy.
Whilst
it is difficult to estimate the number of offences that are related to alcohol
or illicit drug use, it is well established that there is a link between
substance use and crime. The 2005 Offending Crime and Justice Survey included
questions on offending among young people aged 10 to 25 years related to
alcohol and illicit drug use. For 18% of all violent offences and 10% of all
property offences, offenders were under the influence of alcohol. For 3% and 2%
of all violent offences and all property offences, respectively, offenders were
under the influence of illicit drugs (Wilson D. 2006).
Among
the general population, alcohol dependence affects 9% of men and 3% of women in England, additionally
24% of adults drink alcohol in a way that puts them at risk of physical and
psychological harm (McManus S. 2009).
Although
general population surveys significantly underestimate the numbers of dependent
drug users it is believed that around 3% of adults in England show
signs of dependence on illicit drugs (typically cannabis). For other illicit
drugs, 0.4% show signs of dependence on cocaine and 0.1% each show signs of
dependence on crack, ecstasy and heroin/methadone (Department of Health 2011).
Alcohol
use has been linked to the development of a number of chronic conditions
(increased risks of hypertension, stroke, coronary heart disease, liver
cirrhosis and some cancers) and acute consequences (including violence and road
traffic accidents). Using alcohol attributable fractions produced by Public
Health England within the Local Alcohol profiles (LAPE 2014), it is estimated
that in 2012 65% of all alcohol related deaths in England occurred in men. As
well as sex alcohol-related deaths vary by age, with 39% and 46% of deaths
occurring in the ages 35 – 54 and 55 – 74 respectively (ONS 2014).
The
majority of recorded drug-related deaths are related to opioid use and mostly
occur among injecting drug users (Bird S. M. 2010). The main cause of directly
attributable drug related deaths was accidental poisoning whilst using
heroin/morphine. However, deaths from AIDS among injecting drug users accounted
for 8% of all AIDS deaths in England and Wales in
2009 (Davies C. 2010).
Hospital
admissions arising from diseases or conditions directly and indirectly related
to substance use make up a large contribution of the costs to the NHS. Studies
of the health-related costs of substance use indicate an annual spend of nearly
£3bn on alcohol misuse in England and
just under £500m on Class A drug use in England and Wales (Department
of Health 2011). In addition, older people who continue to use drugs and
require the support of health services are emerging as an important but
relatively under-researched population (Department of Health 2011).
In
2008, the Home Office calculated that the costs associated with alcohol-related
crime were between £8.75bn and £14.78bn. These costs were mainly incurred as a
result of less serious wounding, criminal damage, sexual offences and causing
death by dangerous driving. The costs associated with drug-related crime were
last updated in 2003-04 and estimated at £13.32bn. The estimation of these
costs included the following offence categories: fraud, burglary, robbery and
shoplifting (Department of Health 2011). It has also been estimated that there
is a £7bn loss of productivity due to alcohol, and that, for every £1 spent on
drug & alcohol interventions for young people, there are between £5-£8
worth of benefit (Public Health England 2013).
Bird S.
M., Hutchinson S. J., Hay G., King R. Missing targets on drugs-related
deaths, and a Scottish paradox ; 21: 155-9. International Journal of
Drug Policy, 2010.
Davies
C., English L., Lodwick A., McVeigh J., Bellis M. A. United Kingdom
drug situation: annual report to the European Monitoring Centre for Drugs and
Drug Addiction (EMCDDA) 2010. Liverpool: UK Focal Point on Drugs. 2010.
Department
of Health. A Summary of the Health Harms of Drugs. Available
from http://www.nta.nhs.uk/uploads/healthharmsfinal-v1.pdf, 2011.
LAPE. Local
Alcohol Profiles for England. Public Health England, 2014.
McManus
S., Meltzer H., Brugha T., Bebbington P., Jenkins R. Adult psychiatric
morbidity in England, 2007. . The Health & Social Care Information
Centre, 2009.
ONS.
“Alcohol-related deaths in the United Kingdom, registered in 2012.” 2014.
Public
Health England. Alcohol and drugs prevention, treatment and recovery:
why invest? 2013.
