Research and analysis

United Kingdom drug situation 2019: summary

Updated 31 March 2021

1. Prevalence of drug use

The overall prevalence of drug use reported in the UK has remained relatively stable throughout the last decade. However, the most recent surveys covering England and Wales, and Scotland reported the highest prevalence of drug use in the past 10 years.

From the most recent surveys, the prevalence of any drug use in the last year was 9.4% in England and Wales, 12% in Scotland, and 5.9% in Northern Ireland.

Drug use among 15 year olds has risen over the past 5 years. In 2018, 38% of 15 year olds in England, and 21% of 15 year olds in Scotland, said that they had ever used drugs.

The most commonly used drugs have not changed over time. Cannabis is the most prevalent, followed by powder cocaine, MDMA, ketamine and amphetamine.

Synthetic cannabinoid receptor agonists, such as Spice, are widely used in prisons. They were detected in more random drug tests than cannabis in England and Wales in 2018 to 2019. In Scotland, buprenorphine was the most commonly detected drug in addiction prevalence tests carried out in prisons in 2018 to 2019.

2. Drug-related harms

In 2017, 3,284 drug-related deaths (DRDs) occurred in Great Britain using the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) definition, which is deaths caused directly by the consumption of at least one illicit drug.

The drug-related mortality rate per million population in Great Britain using the EMCDDA definition was the highest on record, at 76 per million. The mortality rate in Scotland was 229 per million in 2017, the highest rate reported in Europe in that year.

The prevalence of hepatitis C among people who inject drugs, who were surveyed in England, Wales and Northern Ireland in 2018 was 54%. This is the highest figure in the past decade. In Scotland, the prevalence reported in 2017 to 2018 was 57%.

3. Drug treatment

In 2018, 114,752 individuals started drug treatment in England, Scotland and Wales, a decrease from over 122,000 in 2015.

Across England and Wales, there were 234,101 people in treatment at any time during 2018. The most common primary drug reported by people starting treatment in Great Britain in 2018 was heroin, with cannabis the second most common. In Northern Ireland in 2017, cannabis was the most common primary substance.

4. Main drugs used in the UK

4.1 Opioids

The UK has the largest reported opioid-using population in Europe. In 2017, 57,430 people started treatment for primary opioid use in the UK, which was 35% of everyone starting treatment throughout the European Union (although the total did not include Germany).

In 2018, opioids were mentioned or implicated in around 80% of deaths registered in each of the countries of the UK, with the highest proportion in Scotland (86%).

4.2 Cocaine

Powder cocaine is the most commonly used stimulant in the UK. The prevalence of use in the last year reported in England and Wales in 2018 to 2019 (2.9%) was the highest since 2008 to 2009. Lifetime use among 15 year olds in England increased from 2% in 2013 to 4.2% in 2018, and was 5.4% in Scotland in the same year.

Thirteen per cent of people starting drug treatment in Great Britain in 2018 reported primary use of powder cocaine. There has been a notable increase in the proportion of people starting treatment for powder cocaine use in Scotland and Wales in recent years.

The UK has the highest levels of crack cocaine problems in Europe. Of the approximately 11,000 people who were recorded as starting treatment for primary crack use in Europe in 2017, 65% of these were in the UK.

All countries in the UK have seen large increases in the numbers of deaths involving cocaine (powder or crack) over the past decade.

4.3 Benzodiazepines

The number of deaths in Scotland where benzodiazepines were implicated in or potentially contributed to the cause of death has increased markedly over the past 3 years, from 191 deaths registered in 2015 to 792 deaths in 2018. Most of this increase is due to ‘street’ benzodiazepines, mainly etizolam. Benzodiazepines were mentioned on the death certificate in 60% of DRDs registered in Northern Ireland in 2018.

There has been an increase in the prevalence of 15 year olds in England who have used benzodiazepines at some time in their life, from 0.5% in 2014 to 1.7% in 2018. Prevalence has also risen in Scotland, from 1.7% in 2015 to 2.8% in 2018. This has coincided with reports of increased alprazolam use (‘Xanax’) among school children.

4.4 MDMA and ecstasy

Use of MDMA by children and young adults has increased in recent years. Prevalence among 16 to 19 year olds in England and Wales was 4.5% in 2018 to 2019, the highest since 2001 to 2002. The proportion of 15 year olds who had used MDMA at some time in their lives was 3.9% in England and 6% in Scotland in 2018.

In 2015, just over half (53%) of people starting treatment for primary MDMA use were under 20 years old, but in 2018, 75% of those starting treatment were in this age group.

The number of MDMA-related deaths registered in the UK in 2018 was the highest on record, but was still much lower than the number of deaths involving heroin, benzodiazepines or cocaine. In England and Wales, there was an increase in the number of deaths among people aged under 30.

4.5 Ketamine

Prevalence of ketamine use in the last year among adults in England and Wales is currently the highest on record, at 0.8%. People aged 16 to 24 are almost 4 times as likely to use ketamine as all adults, with 2.9% reporting last year use in England and Wales in 2018 to 2019, and 2.8% in Scotland in 2017 to 2018.