Cocaine and mental illness – increasingly people are being admitted to hospitals in England with cocaine-induced mental disorders. NHS Digital figures show that three times more patients with mental or behavioural problems linked to cocaine are presenting in hospitals, as compared to a decade ago. In 2017-18, there were 14,470 hospital admissions – 40 people per day. This compares to 5,148 hospital admissions in 2007-8 or 14 people per day.
In this blog, we look at why hospital admissions related to cocaine and mental illness have risen so sharply in 10 years. Specialist addiction treatment for people with a dual diagnosis must be prioritised.
Cocaine and Mental Illness in England – What’s Causing the Problem?
1. The UK is the cocaine capital of Europe
In Britain, people use cocaine more than in any other part of Europe. In England and Wales, 4% of young adults aged 16-34 took cocaine in the past year. This year, cocaine deaths reached their highest ever numbers.
The more people use cocaine, the more likely they are to experience mental health problems. As reported by the Guardian, Professor Adam Winstock (founder of the Global Drugs Survey), said: “Mental and behavioural disorders due to cocaine are varied, but the risk of experience of almost all of them are dose-dependent – the more of the drug you take and the more frequent you take it, the higher your risk of experiencing them.”
2. Public funding for addiction rehabs has declined
As reported in the Guardian, UKAT made freedom of information requests about the number of publicly funded addiction rehabs. In Britain, there were 195 in April 2013. Today there are only 139.
With fewer specialist services to treat cocaine addicts, more people with co-existing mental illness will find themselves in crisis. Hospitals and GPs are not equipped to provide intensive addiction interventions to people with a dual diagnosis. At best, they can support people in crisis and refer to other services – but when people cannot access specialist addiction help, this leads to the revolving door effect in frontline health services.
University of York mental health lecturer, Harry Sumnall, said: “It is perhaps unsurprising that people who experience problems with cocaine are presenting directly to hospitals in the absence of these protective services.”
3. Changes in cocaine supply and purity
A United Nations report published in September 2018 estimated that “enough coca was grown [in Colombia] to produce 1,379 tonnes (1,520 tons) of cocaine – up 31% in 2016.”
This increased supply of cocaine is reaching Europe via multiple organised criminals with higher purity drugs being traded. New methods of drugs distribution in the UK have emerged including the county lines phenomenon – where city-based dealers recruit vulnerable or young people in smaller towns to sell drugs for them. Reduced stigma around taking cocaine, including crack cocaine in some cases, may also be contributing to higher usage and hospital admissions.
4. Parity of esteem is still needed for mental health services
Funding for mental health services has been high on the political agenda for at least six years – ever since achieving “parity of esteem” between mental health and physical health became a political pledge. Since 2013, politicians from all parties have said that the funding gap between mental healthcare and physical healthcare must be reduced. In a 2018 survey by the Royal College of Nursing, however, only 17% of mental health nurses said the UK had been successful in delivering mental health equality.
Without effective support for people with severe and enduring mental illnesses, such as schizophrenia and psychosis, more people become vulnerable to illegal drug use. With common mental illnesses, such as depression and anxiety, long waiting times for talking therapies and a reliance on long-term prescriptions, are factors in why people turn to drugs like cocaine. It’s a vicious circle, however, because cocaine abuse typically makes mental illness worse over time. Cocaine is also particularly dangerous when mixed with other drugs or alcohol.
5. Improvements to hospital coding of cocaine and mental health admissions
Some of the increase in mental health hospital admissions related to cocaine may result from better administration. However, data recording is unlikely to account for the bulk of the increase, considering the evidence on the increased supply of cocaine, greater usage and record numbers of cocaine deaths.
Cocaine and Mental Illness – Addiction Treatment for People with a Dual Diagnosis
At UKAT, we continue to campaign for fair and fast access to addiction services nationwide – including specialist addiction treatment for people with a dual diagnosis. Life-saving addiction support should not be a postcode lottery. In many local authority areas, severe cuts to drug and alcohol treatment correspond with an increase in drug-related deaths. Where mental health services are also under pressure, people with a dual diagnosis can struggle to get the help they need.
There are very cost-effective drug and alcohol rehabs available in England. UK Addiction Treatment Centres offer residential addiction programmes that are affordable to commissioners of addiction treatment, as well as private clients. Our services are CQC-registered and consistently achieve positive treatment outcomes.
If you need help for cocaine and you also have a diagnosed mental illness, please contact UKAT for advice on addiction treatment. We’ll listen to what’s going on for you and advise on our detox and rehab programmes for people with a dual diagnosis.