Numbers accessing treatment

Public Health England’s National Drug Treatment Monitoring System has reported that while 595,000 adults in England were “drinking at dependent levels and potentially in need of specialist treatment”, only 109,000 accessed alcohol treatment services in 2016-7, i.e. 18% or just under 1 in 5. This figure of 595,000 dependent drinkers is based on a study by Sheffield University and King’s College London, and equates to 1.4% of the adult population of England. The same analysis has not be done in Wales, but there is no reason to suppose that the percentage of dependent drinkers in the population would be very different.

Using the 1.4% estimate from England would mean that around 36,000 adults in Wales would be alcohol dependent. The total number of people starting substance misuse treatment in Wales in 2016-17 was 16,406, of whom around 53% had been assessed for problematic alcohol use and around 47% for problematic use of other drugs. Since that 53% will include many other drinkers who are not alcohol dependent, it is not possible to make a meaningful comparison with the English figures above.

Polydrug use

Firm information on the nature and extent of polydrug use is scarce, although all drug and alcohol services recognise that it happens. The UK Government’s 2017 Drug Strategy states that “use of multiple drugs (‘poly-substance misuse’)…poses an evolving challenge”. The Welsh Government’s Substance Misuse Annual Report and Forward Look for 2017 says that “[hospital] admissions data suggests that use of multiple drugs may be increasing”.

Probably the most comprehensive source of information is the European Monitoring Centre for Drugs and Drug Addiction’s report on polydrug use, based on data on young adults (15–34 years) from 2005 to 2008 in nine EU Member States, including the UK. They found that:

• The use of multiple substances is a widespread pattern of drug use in Europe
• Polydrug use reflects both the increasingly wide range of drugs available and the willingness of different groups of young people to experiment in the use of psychoactive substances
• The data indicates the existence of three distinct populations of polydrug users:
• • Co-users of heroin and cocaine, who are often marginalised
  • Socially integrated cocaine inhalers and alcohol users
  • Younger co-users of cannabis and alcohol.
• Alcohol is almost always the first drug used by young people and is a fundamental component of most polydrug use profiles
• The strongest associations between heavy alcohol use and illicit drug use were found in the countries with the lowest prevalence of heavy alcohol use (Cyprus, France, Italy, Portugal), and the weakest associations in those countries where frequent or heavy alcohol use is more widespread, such as Ireland and the United Kingdom.