Statistics on Drug Misuse, England, 2019

This part presents information on the number of hospital admissions (inpatient settings only) related to drug misuse.

Three measures for the number of drug related hospital admissions have been calculated using Hospital Episode Statistics (HES) data:

• Measure 1 – hospital admissions with a primary diagnosis of drug-related mental and behavioural disorders – referred to as admissions for drug related mental and behavioural disorders. 
• Measure 2 – hospital admissions with a primary diagnosis of poisoning by drugs, that are listed as controlled under the Misuse of Drugs Act 1971 (includes both intentional and unintentional poisoning) – referred to as admissions for poisoning by drug misuse;

For measures 1 and 2, a drug related mental and behavioural disorder, or poisioning by drug misuse were the main reason for the admission (primary diagnosis).

• Measure 3 – hospital admissions with a primary or secondary diagnosis of drug-related mental and behavioural disorders – referred to as admissions where drug related mental and behavioural disorders were a factor.

Measure 3 is a broader indicator of drug related admissions; this is because a secondary diagnosis does not necessarily mean that a drug-related mental and behavioural disorder was a contributing factor for the admission, but may instead just have been relevant to a patient’s episode of care. The data quality of secondary procedures has increased over time so increases in admissions compared to 10 years ago may partly reflect an improvement in data quality as well as an increase in activity. See the data quality statement for more information.

More detail on the methods used to calculate these measures is provided in Appendix B.

The latest data is for 2018/19.

This section covers analysis of measures 1 and 2 (see above), which is those admissions where drug misuse was the primary reason for the admission (whether as a result of drug related mental and behavioural disorders or poisoning).

Admissions by year

In 2018/19 there were 7,376 admissions for drug related mental and behavioural disorders, a 2% increase on 2017/18 (7,258), but 14% less than 3 years ago in 2015/16 (8,621). This was preceeded by a period of mostly increases; the current level still being 30% higher than 2008/09 (5,668). The number of admissions for 2018/19 represents a rate of 13 per 100,000 population.

There were 18,053 admissions for poisoning by drug misuse, a 6% increase on 2017/18, and 16% higher than in 2012/13 (15,580). This measure was subject to a methodological change in 2012/13 and so data is not comparable before then (see the Data Quality Statement for more information). The number of admissions for 2018/19 represents a rate of 33 per 100,000 population.

Time series data is available as a rate per 100,000 population in the accompanying data tables, and shows similar trends.                                                

Admissions by sex

More men than women were admitted to hospital for drug related mental and behavioural disorders (74% male), but similar proportions for admissions due to poisoning by drug misuse.

Admissions by age

Admissions for drug related mental and behavioural disorders, and for poisoning by drug misuse, showed similar age profiles. Levels were highest for younger people (apart from those under 16), peaking between ages 25 and 34. Admissions for drug related mental and behavioural disorders are very uncommon in those aged under 16 and over 64.

Please note, admission rates per head of population are included in the data tables and show a similar age profile.

Although admissions amongst older people are lower (see previous charts), numbers are rising most in those aged over 45. 

Admissions for poisoning by drug misuse have increased 36% in those aged 45 and over since 2012/13 (from 4,428 to 6,025), compared with an 8% increase for those under 45.

This is also the case for admissions for drug related mental and behavioural disorders, although the numbers are smaller.

Admission rates by deprivation level (per 100,000 population) 

Admissions were mapped to Index of Multiple Deprivation deciles and rates age standardised using the European standard population (see Appendix B for more information).

Admission rates for both drug related mental and behavioural disorders, and for poisoning by drug misuse increase with the level of deprivation. 

Admissions for drug related mental and behavioural disorders were around 6 times more likely in the most deprived areas (30 per 100,000 population), compared to the least deprived areas (5 per 100,000 population).

Admissions for poisoning by drug misuse were around 5 times more likely in the most deprived areas (70 per 100,000 population), compared to the least deprived areas (14 per 100,000 population).

Admission rates by Local Authority (per 100,000 population)

Admission rates have been age standardised using the European standard population (see Appendix B for more information).

Drug related mental and behavioural disorders

Stoke-on-Trent had the highest admission rate with 68 per 100,000 population, followed by Liverpool (42) and Kingston upon Hull (40).

8 LAs recorded rates of less than 5 per 100,000 population; Thurrock, Bracknell Forest, Dudley, Walsall, Kent, Enfield, Medway and Isles of Scilly.

Poisoning by drug misuse

St. Helens had the highest admission rate with 95 per 100,000 population, followed by Middlesborough (91), and Blackpool (80). (Excludes Isles of Scilly where the rate was 126 per 100,000 population, but involves small numbers - less than 8 cases)

The lowest rates were in Waltham Forest (8 per 100,000 population), Redbridge (9), and Haringey (9).

19 of the 20 lowest rates (all below 15) were in London boroughs.

An additional visualisation of this data, including time series, is available at the link below.

This section covers analysis of measure 3 (see top section), which is those admissions where a drug related mental and behavioural disorder was the primary or a secondary diagnosis. A secondary diagnosis does not necessarily mean that a drug-related mental and behavioural disorder was a contributing factor for the admission, but may instead just have been relevant to a patient’s episode of care. 

Admissions by year and sex

There were 96,705 admissions with a primary or secondary diagnosis of drug related mental and behavioural disorders. This is an increase of 11% on 2017/18, when there were 86,966 admissions. Some of this increase may be due to hospitals being more likely to record secondary diagnosis codes than they were previously. See the Data Quality Statement for more information.

The number of admissions for 2018/19 represents a rate of 175 per 100,000 population.

A breakdown of these admissions by primary diagnosis can be seen in table 3.2.

More men than women were admitted. In total, 69% of the patients were male.

Admissions by age

Admissions were highest for people aged between 25 and 44, with those age groups representing 54% of all patients. Admissions are uncommon in those aged under 16 and over 75.

Admission rates by deprivation level (per 100,000 population) 

As with the other measures, admission rates increase with the level of deprivation. 

Admissions where drug related mental and behavioural disorders were a factor were nearly 9 times more likely in the most deprived areas (456 per 100,000 population), compared to the least deprived areas (53 per 100,000 population).

Admission rates by Local Authority (per 100,000 population)

Hartlepool had the highest admission rate with 675 per 100,000 population, followed by Blackpool (522), and Middlesbrough (481).

The lowest rates were in Thurrock (64), Rutland (45), and Isles of Scilly (0). 

An additional visualisation of this data, including time series, is available at the link below.

Definitions vary between countries. See source publications at the links below for further details.

Scotland

Over the past 20 years, there was a fourfold increase in the rate of drug-related general acute hospital stays (from 51 to 199 stays per 100,000 population), with a sharper increase observed in recent years.

After a lengthy period of stability, the rate of drug-related psychiatric stays increased from 29 to 40 stays per 100,000 population between 2014/15 and 2016/17, before decreasing slightly in 2017/18 (38).

Stays among individuals aged 35 and over increased over the past 20 years. Individuals aged 35-44 years were most common among drug-related patients in general acute or psychiatric hospitals. Drug-related general acute patient rates for this group increased more than tenfold from 37 to 399 patients per 100,000 population between 1996/97 and 2017/18.

In 2017/18, approximately half of the patients with a drug-related general acute or psychiatric hospital stay, lived in the most deprived areas in Scotland.

Wales

The overall number of hospital admissions for poisonings with named illicit drugs has increased by 4.4 per cent from 6,488 in 2017-18 to 6,786 in 2018-19. Compared to 2014-15 there has been a 17.2 per cent increase in illicit drug admissions.

Admissions were 6 times higher amongst those from the most deprived areas compared to least deprived.