Statistics on Drug Misuse, England 2020

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 poisoning 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 have just 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 2019/20

COVID-19 and the production of statistics:  Due to the coronavirus illness (COVID-19) disruption, it would seem that there is some effect on the quality and coverage of some of our statistics in relation to the 2020/21 period. It is known that many hospitals are reporting zero or significantly less activity across one or more datasets for March 2020 onwards. The HES data in this publication relates to 2019/20, therefore, the end of the reporting period for this publication includes some of the pandemic period but this is estimated to have a negligible impact on the data.

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 2019/20 there were 7,027 admissions for drug-related mental and behavioural disorders, a 5% decrease on 2018/19 (7,376), and 18% less than the highest recorded number of admissions of the time series, in 2015/16 (8,621). This was preceded by a period of mostly increases; the current level still being 21% higher than 2009/10 (5,809). The number of admissions for 2019/20 represents a rate of 12.5 per 100,000 population.

There were 16,994 admissions for poisoning by drug misuse, a 6% decrease on 2018/19 (18,053), but 9% 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 2019/20 represents a rate of 30.5 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 (73% male). However, there were similar proportions of men and women admitted to hospital 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 lowest for those aged under 16 and over 64.

Although admissions amongst people aged 45 and over are lower (see previous charts), numbers have increased more over time for this age group compared to those aged under 45.

Admissions for drug-related mental and behavioural disorders increased by 75% in those aged 45 and over since 2009/10 (from 744 to 1,300), compared with a 13% increase for those aged under 45 (5,048 to 5,725).

Admissions for poisoning by drug misuse increased by 30% in those aged 45 and over since 2012/13 (from 4,428 to 5,777), compared with a 1% increase for those aged under 45 (11,152 to 11,210).

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 5 times more likely in the most deprived areas (27 per 100,000 population), compared to the least deprived areas (5 per 100,000 population).

Admissions for poisoning by drug misuse were also around 5 times more likely in the most deprived areas (69 per 100,000 population), compared to the least deprived areas (13 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

Kingston upon Hull had the highest admission rate with 49 per 100,000 population, followed by Liverpool (48), Stoke-on-Trent (44) and St Helens (43).

13 LAs recorded rates of less than 5 per 100,000 population (shown in descending order): Lincolnshire, Barnet, Enfield, York, Dudley, Sandwell, Walsall, North East Lincolnshire, Rutland, Wolverhampton, Merton, Windsor and Maidenhead and the Isles of Scilly.

Poisoning by drug misuse

Middlesbrough had the highest admission rate with 106 per 100,000 population, followed by the Wirral (80), St Helens (77) and Knowsley (76).

9 LAs recorded rates of less than 10 per 100,000 population (shown in descending order): Rutland, Enfield, Waltham Forest, Barking and Dagenham, Brent, Newham, Redbridge, City of London and the Isles of Scilly. 

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 gender

There were 99,782 admissions with a primary or secondary diagnosis of drug-related mental and behavioural disorders. This is an increase of 3% on 2018/19, when there were 96,705 admissions. 

The number of admissions for 2019/20 represents a rate of 180.5 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 53% of all patients. Admissions are lowest 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 over 8 times more likely in the most deprived areas (470 per 100,000 population), compared to the least deprived areas (55 per 100,000 population).

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

Hartlepool had the highest admission rate with 606 per 100,000 population, followed by Blackpool (569), and Liverpool (485).

The lowest rates were in Bracknell Forest (77), Windsor and Maidenhead (66), and Rutland (65). 

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