On 1st November 2018, Public Health England released their annual alcohol and drug treatment statistics. The National Drug Treatment Monitoring System (NDTMS) data for 2017-18 shows a 4% drop in access to addiction treatment. 11,403 fewer adults accessed help than in 2016-17. The addiction treatment population has been falling every year since 2009-10, apart from a small rise in 2013-14.
UKAT continues to call for urgent change. Central government and local authorities must act now to prioritise addiction treatment access.
The NDTMS statistics paint a sombre picture. Increasingly, people who suffer from addiction in England cannot access specialist help.
Addiction is a major public health issue and should be treated as such. Like any other prevalent healthcare need, the solution is providing high-quality treatment. Addiction won’t go away if it’s ignored or routinely criminalised. When people have diabetes, cancer, heart disease or a stroke, they rightfully expect specialist healthcare to be available – whether or not their illness has developed due to genetic, environmental and/or lifestyle factors.
So why is addiction treatment access increasingly sidelined? 43,277 fewer people received addiction help this year, as compared to 311,667 in 2009-10.
UKAT has been calling throughout 2018 for a reverse to cuts in addiction treatment budgets. Our freedom of information requests to all local authorities earlier this year revealed the scale of the decline in addiction help. The level of unmet need across the country has escalated to crisis levels.
Currently, around four in five people who need alcohol treatment are not getting help. Of the 589,101 adults with alcohol dependency, over half a million received no help at all.
To illustrate the scale of this unmet need, this exceeds the population of Liverpool.
The numbers who did access alcohol help dropped by 6% since 2016-17 – and by 17% since 2013-14. Yet, according to Public Health England, “alcohol dependency estimates have remained relatively stable over the last five years, which suggests that the falls in the numbers of alcohol-dependent people accessing treatment do not reflect a fall in prevalence.”
How does Public Health England explain this? They carried about an inquiry into the falling alcohol treatment population (published 1st November 2018). In the areas where alcohol treatment fell, the PHE report highlights service reconfigurations, treatment budget reductions, increased caseloads and de-prioritisation of the needs of alcohol users. Where alcohol treatment increased, the PHE inquiry found a proactive and strategic commitment to reducing alcohol harm. Essentially, where priority is given to alcohol treatment, more people access help for alcohol addiction.
Furthermore, the PHE annual report states: “Alcohol-only clients had the highest rates of successful treatment exits, with 61% completing treatment successfully, the same proportion as the previous year.” So, where people can get alcohol treatment, they are the most likely to respond well.
In terms of drug addiction treatment access, the overall picture shows declining numbers getting help.
Opiate users remain the majority who access addiction treatment. 53% of those who received help for addiction in 2017-18 were dependent on opiates – 141,189 people. This is a 4% drop from the previous year.
There was an 18% increase in people receiving treatment for crack cocaine (without opiate use). This correlates with data showing an upsurge in supply and demand of crack cocaine, including changes in the drug’s affordability and purity. However, this group is only a small proportion of the addiction treatment population – 4,301 or 1.6%.
Fewer people who presented in treatment needed help with new psychoactive substances (NPS), ecstasy or mephedrone. Those who needed help with NPS were the most likely to be homeless.
For the first time, Public Health England has published information about how many addicts in treatment have children under 18:
25,593 people who started treatment in 2017-18 lived with 46,109 children.
A further 38,852 people said they were parents but did not currently live with their children.
This information points to the wider impacts of addiction within families. Where addiction treatment access is restricted, there are higher levels of untreated addiction. This exposes children and young people to significant risks, including an increased likelihood that they will develop an addiction themselves.
When so much of the data highlights cutbacks and unmet needs, where is the hope for addicts and their families in England?
UKAT will continue to speak out publicly about the evidence. We know that where there are investment and commitment to addiction treatment access, greater numbers get the help they need.
Addiction problems contribute to major physical diseases, including heart disease, cancers, stroke and diabetes – so, investment in addiction treatment access is also an investment in our nation’s physical health.
Addiction problems also co-exist with and contribute to mental health disorders. So investment in addiction treatment access is also an investment in our nation’s mental health.
Addiction affects the whole family. Children and young people benefit when their parents access addiction help – family relationships can be rehabilitated, often as part of the addiction treatment programme. So, investment in addiction treatment access is also an investment in our children and young people.
Addiction affects people’s ability to work and engage in society. So investment in addiction treatment access is also an investment in our nation’s productivity.
There is so much to gain for millions of people in our society – for addicts, their families and their communities. Visionary policies, strategies and leaders can create the changes we need.
For advice on addiction treatment access, please contact UKAT. We have a range of treatment options – including outpatient counselling, residential rehab and secondary care.