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Fewer young people than ever are entering treatment for heroin and crack
problems, and more people of all ages are successfully completing their treatment,
says the NTA. What’s behind the trends, and can they be maintained?
DDN
reports
News focus |
Analysis
HOW DO WE KEEP UP THIS
MOMENTUM?
6 |
drinkanddrugsnews
| November 2012
www.drinkanddrugsnews.com
Figures released by the NTA last month (see news
story, page 5) show that the number of young adults
entering treatment for heroin or crack is now at its
lowest recorded level.
In 2011-12, 4,268 18-to-24-year-
olds came into treatment for heroin, down from 5,532 the
previous year and from more than 11,000 in 2005-06.
Overall drug use – problematic or otherwise –
among the young also appears to be falling, with 19
per cent of 16-to-24-year olds reporting using drugs in
2011 compared to 25 per cent in 2005. Fears that large
numbers of young people would start to experience
problems with substances like mephedrone also
appear – so far – to be unfounded.
‘While the number treated for mephedrone has
risen in recent years, this has been offset by a
corresponding decline for similar substances, such as
ecstasy,’ says the NTA’s report, with the actual
numbers remaining ‘small compared to other drugs’.
The total number of 18-to-24-year-olds coming into
treatment for the first time for any drug fell from
18,500 in 2005-06 to 12,655 in 2011-12, a trend that’s
‘particularly encouraging’, says the agency.
As the report states, the only age group where the
numbers entering treatment are going up is the over-
40s, who now make up almost a third of the entire
treatment population. However, there’s ‘no evidence of
swathes of people in their 40s and 50s starting to use
heroin and crack’, says NTA chief executive Paul Hayes.
‘It’s a population that started using 20 or 30 years ago.’
Much has been made of these trends in the
media, so what’s behind them? ‘I’m surprised that
everyone’s surprised,’ says Hayes. ‘It’s been going on
for ten years.’ The ‘original pool’ of people with heroin
and crack problems is shrinking, he points out, while
the current recession has so far not produced the
same levels of youth employment that led to the
heroin epidemic of the 1980s.
‘I also think that young people are savvier about
drugs like heroin and crack than they were in the ’80s.
And, like all social phenomena, drug use will ebb and
flow as fashions change. One of my pet theories is
that there’s been a reduction in smoking, and if there
is a gateway drug – particularly to cannabis – then it’s
tobacco. It’s also cheaper to drink alcohol than smoke
cannabis, and there’s a plausible argument that the
stronger cannabis that tends to dominate the market
now puts a lot of people off.’
There is also a tendency to talk about the
‘demographic of young people as something that
doesn’t change’, he says. ‘People are growing up in
different familial and cultural environments than they
were in the ’80s.’
While all of this is encouraging, as the agency says,
Hayes isn’t complacent, warning of the risks associated
with the economic climate and spending squeeze. ‘The
lesson from Greece is that disinvestment comes at a
heavy price,’ he says, with cuts in treatment and harm
reduction services leading to the number of newly
diagnosed HIV cases among injecting drug users rising
from around ten in 2009-10 to 190 the following year.
In the UK, however, the biggest funding threat
remains to the ‘surrounding services – those allied to
long-term recovery’, he stresses. Direct investment in
drug treatment will form part of the budget going to local
authorities from next year and there will be ‘mechanisms
to ensure that’s protected’, he says, adding that ‘we
would expect it to be in local authorities’ interests to
continue to invest at that level’. As Public Health
England will have responsibility for alcohol as well as
drug treatment, however, another challenge will be
balancing the two – ‘meeting the unmet need around
alcohol without disinvesting in drugs’.
The UK’s treatment system has been ‘big enough to
accommodate anyone who wants to take advantage of
it’ for a number of years now, with methadone
continuing to play a vital role, but the oft-made case for
a need for more rehab places is overstated, he says.
‘Many people in rehab drop out and end up in the
community system, and there’s no overwhelming
evidence of a huge level of pent-up demand to go into
rehab that’s not being met. In a small number of cases
there are commissioners who are more reluctant to
provide it than we’d like, but the big story isn’t
community versus rehab, it’s the difference between the
rehabs themselves.’
On the subject of polarisation, arguments around
decriminalisation and legalisation add little of value to
the debate about improving treatment outcomes, he
believes. ‘Both extremes of this argument don’t want to
acknowledge that things are getting better, because that
doesn’t fit the radical change that either Peter Hitchens
or Danny Kushlick want. It’s very difficult to get a hearing
for boring, bureaucratic clinical stuff. Seventy seven per
cent of MPs [in a UKDPC-commissioned ComRes poll]
said the system wasn’t working. What I’d like to say to
them – with more people successfully completing their
treatment and drug-related crime falling – is what would
it look like if it was?’
Drug treatment 2012: progress made,
challenges ahead
available at www.nta.nhs.uk
‘Young people are
savvier about
drugs like heroin
and crack than
they were in the
’80s. And, like all
social phenomena,
drug use will ebb
and flow as
fashions change.’
Paul Hayes