How many people are addicted?

Addiction or problematic use is a difficult concept to measure

Those with drug-related problems tend to be difficult to find, and addiction is difficult to measure. Experts consistently fail to agree on what constitutes an addict, problematic use or problematic user. Estimates as to how many people are experiencing drug problems have to be drawn from different sources, using different ways of measuring.

Numbers receiving help for alcohol and drug problems

The National Drug Treatment Monitoring System (NDTMS) statistics report presents information on adults (aged 18 and over) who were receiving help in England for problems with drugs and alcohol in the period 2017 to 2018.

There were 268,390 adults in contact with drug and alcohol services in 2017 to 2018, which is a 4% reduction from the previous year (279,793).

The number of people receiving treatment for alcohol alone decreased the most since last year falling by 6%, (80,454 to 75,787) and by 17% from the peak of 91,651 in 2013 to 2014.

There were an estimated 589,101 adults with alcohol dependency in need of specialist treatment in 2016 to 2017. These alcohol dependency estimates have remained relatively stable over the last 5 years, which suggests that the falls in the numbers of alcohol-dependent people accessing treatment does not reflect a fall in prevalence, with only 1 in 5 of those in need of treatment currently receiving it.

People in treatment for opiate dependence made up the largest proportion of the total numbers in treatment (53% or 141,189). This is a fall of 4% since the previous year.

The number of people entering treatment who were in the non-opiate group and the non-opiate and alcohol group (35,473) was broadly the same as the previous year (35,491). However, the number of people being treated for crack cocaine problems – people using crack but not opiates – increased by 18% since last year (3,657 to 4,301) and 44% since the year before that (2,980 to 4,301).

The increase of numbers of people in treatment for crack but not opiates during 2017 to 2018 was seen in all age groups except 65 years and over.

There was also a 3% increase in people entering treatment for both crack cocaine and opiate problems (21,854 to 22,411), which was seen primarily in those aged 35 and over. This represents over half (54%) of people entering treatment for opiate problems in 2017 to 2018, compared to 35% in 2005 to 2006.

The latest published estimates of crack cocaine use in England (2014 to 2015) reported a 10% increase in the numbers of people estimated to be using the substance since 2010 to 2011 (166,640 to 182,828).

It is likely that the recent increase in the number of people entering treatment for crack problems reflects the rise in the prevalence of the drug’s use. The increase in the number of new users may be in part caused by changes in the purity and affordability of crack cocaine and patterns of distribution over the last few years. The latest report from the UK Focal Point on Drugs has information about increases in purity.