Prevalence estimates of opiate and crack cocaine use by local area were updated by the Office for Health Improvement and Disparities (OHID) in October 2023. The report presents opiate and / or crack use (OCU) prevalence estimates for local authority areas across England, based on data relating to the financial year 1 April 2019 to 31 March 2020. ‘OCU’ refers to use of opiates and/or crack cocaine. It does not include the use of cocaine in a powder form, amphetamine, ecstasy or cannabis. Although many opiate and/or crack users also use these drugs it is very difficult to identify exclusive users of these drugs from the available data sources.

It should be stressed that these figures are estimates. They should always be interpreted in conjunction with their associated confidence intervals (CI), which are specified in each table. The confidence intervals show the range within which there is a 95% certainty that the true value exists, though it is most likely to lie near the estimate itself.

As can be seen, it is estimated that 2,927 people are using either opiates and/or crack cocaine in Wakefield District (2019/20), of which 1,658 people are using opiates only, and 382 people are using crack cocaine only1. The number of people using opiates only per 1,000 population is significantly higher than the England rate, but the number of people using crack only per 1,000 population is similar to the England rate.

In 2021/22 there were 1,565 adults in treatment for opiate use, 275 in treatment for non-opiate use, and 150 in treatment for non-opiates and alcohol use ². There are more males than females in treatment. The age profile of those in treatment for opiate use is older and this has been an increasing trend, while the numbers of younger adults in treatment for opiates use has fallen markedly. These sex and age patterns are typical of the picture nationally. Those in treatment for non-opiate use are likely to be younger.

There has been a gradual downward trend in the number of adults in treatment for opiate use and the numbers in treatment for non-opiate use has increased again over the past couple of years. The number of young people (<18) in treatment has fallen over the past couple of years, in part as a consequence of comprehensive case reviews and subsequent treatment exits. 70% of young people in treatment in 2021/22 were male.

National data suggest that adults who stop using illicit opiates in the first six months of treatment are almost five times more likely to complete treatment successfully than those who continue to use. In 2021/22, 65% of adults were no longer injecting at six months review, higher than the England average (57%) ³. Rates of abstinence from drugs at six months review were similar or higher than the England average for all drug types ³.

Wakefield District now has the highest rate of deaths from drug use in the Yorkshire and Humber region ⁴. Numbers of these deaths have increased markedly over the last few years. The rate of hospital admissions for drug poisonings is also higher than the England average ³.

In the Wakefield District Adult Health Survey 2023, 3% of respondents said they use any drugs at least monthly or weekly. This varied by ward, with those respondents in Wakefield West and Stanley and Outwood East significantly more likely than the average overall (6% and 7% respectively) and those respondents living in Wakefield Rural and Normanton wards significantly less likely than the average overall (both 0%). Respondents indicated that Cannabis was the only drug being used frequently (3% of people said at least monthly and 10% had tried it once or twice), but 5% of people said they had used powder cocaine once or twice, 4% said they had used Ecstasy once or twice and 2% had used amphetamine, ketamine or nitrous oxide once or twice. Only 1% of respondent said they had illegally obtained prescription drugs once or twice or used image and performance enhancing drugs once or twice ⁹.

The Wakefield District School Health Survey asks Year 9 secondary school pupils about some of their experiences of drugs. In 2022, 14% of Year 9 pupils said they had ever been offered cannabis and 4% said they had ever taken cannabis ⁸. 7% of Year 9 pupils had ever been offered other drugs, but only 2% had ever taken other drugs. Young carers and pupils with special educational needs were more likely than their counterparts to say they have ever been offered or taken drugs.

Year 9 pupils living in the South East of the district were more likely to have ever taken drugs than pupils living elsewhere.

From Wakefield District JSNA: School Health Survey 2022

Drugs offences are categorised into a wide number of offence codes based on drug type. These are broadly grouped into possession offences and trafficking offences (includes supply, production and unlawful importing and exporting).

Within Wakefield District there were 1,097 drug offences recorded by the police in the 12 months to the end of September 2022 ¹⁰. The longer-term trend had seen a marked reduction in drug crime between 2013 and 2018, followed by an increase. There was a further increase in offences being recorded during the early part of the COVID-19 pandemic because of proactive police activity in crime hotspots during the first lockdown. This was sustained, in part due to increased enforcement activity as part of the Project ADDER (Addiction, Diversion, Disruption, Enforcement and Recovery) programme. Wakefield joined the ADDER programme in July 2021, and the programme as a whole ended in March 2023.

The Wakefield Neighbourhood Impact Team were initiated (in October 2021) through funding from Project ADDER to target drugs supply chains and related criminality whilst also helping those with drug addiction on their way to recovery. In their first year they seized £4m of drugs

Section 23 Misuse of Drugs Act (1971) also allows the police to stop and search people and vehicles if they have reasonable grounds to suspect that someone is in possession of a controlled drug. There were around 850 such stop and searches across Wakefield District in 2022, a similar number to the previous year. There was no further action in around two-thirds of stops, but 15% resulted in an arrest, 19% resulted in community resolution and 2% of people were issued a summons or charged by post ¹¹.

Nationally, the majority of Class A drug seizures are made by the Border Force, while seizures of cannabis plants are nearly exclusively an issue for local police. In 2021/22, nearly 20,000 cannabis plants were seized by police across West Yorkshire, and 50kg of herbal cannabis¹².

Data from the Crime Survey for England and Wales (CSEW) showed no change in the overall level of any drug use in the last year for the year ending June 2022 compared with the year ending March 2020 ⁵. Approximately 1 in 11 adults aged 16 to 59 years (9.2%; approximately 3 million adults) and approximately 1 in 5 adults aged 16 to 24 years (18.6%; approximately 1.1 million adults) reported last year drug use in the year ending June 2022.

There was a reduction in the number of adults reporting having taken any Class A drug in the last year compared with the year ending March 2020. In the year ending June 2022:

• 2.7% of adults aged 16 to 59 years had taken a Class A drug in the last year; a fall of 22% compared with 3.4% in the year ending March 2020
• 4.7% of adults aged 16 to 24 years had taken a Class A drug in the last year; a fall of 37% compared with 7.4% in year ending March 2020

Class A drugs are often taken in social situations, therefore decreases in the use of Class A drugs may be the result of the COVID-19 pandemic and government restrictions on social contact. Evidence from the Global Drug Survey: COVID-19 special edition showed around 40% of respondents reported using ecstasy and cocaine less often than before the coronavirus pandemic. At least 80% reported the reason for doing so was that they have less occasions where they would use these drugs.

Cannabis is the most common drug used (16% of young adults and 7% of all adults used it in the past year). Powder cocaine is the second most commonly used drug among all adults (2.% used) and young adults (4%), while nitrous oxide is the third most commonly used drug (4% of young adults used in the past year, down from 9% in the year to March 2020). The trend in Ecstasy use, the fourth most common drug taken had been fairly flat until the most recent year, and then fell, probably as a consequence of the pandemic.

The prevalence of drug use is highest amongst the younger age groups and tends to decline with age. Drug use is also higher among men than women.

Drug use is lower among minority ethnic groups than among the White population. While reported drug use prevalence is highest among those from mixed ethnic background, particularly cannabis use, when the younger average age of this group is taken into account, their drug use levels are similar to those in the White population. The lowest overall levels of drug use are reported by people from Asian backgrounds.

All the points above refer to findings from national surveys which can’t be broken down to local authority level. We must assume they are representative of patterns of drug use in Wakefield District, although we might have cause to challenge that assumption.

Among younger adults (aged 18 to 22), the most common reason for taking drugs is for recreation ⁶. Smaller numbers say it’s just something to do, and others say it helps them deal with stress or as means of self-medicating for an existing mental health condition. Among all adults, drug use is more common among people who have low levels of happiness, self-worth and life satisfaction, or high levels of anxiety. In secondary school pupils in England, there has been a significant increase in pupils saying they take drugs to forget about their problems (up from 16% in 2011 to 27% in 2021, of those that use) (Smoking, Drinking and Drug Use among Young People in England, 2021). The trend in personal well-being in Wakefield District isn’t very different from that seen nationally, but both have seen a decrease in well-being over several recent years (which started before the pandemic) followed by a marked improvement in the latest year (2021/22).

Among younger adults (aged 18 to 22), the most common reasons for not taking drugs are just not having considered it; being concerned about the effects that taking drugs would have on their health; and general concern about the effects the drugs would have on them. Only 25% say they abstain because they are worried about the illegality of drugs.

The majority (48%) of adults obtain drugs from a friend, neighbour or colleague. Many adults (39%), and especially younger adults (56%), say that drugs are easy to obtain.

The number of secondary school pupils nationally who have ever taken drugs has tended to decline in recent years (18% of pupils aged 11 to 15 reported they had ever taken drugs in 2021, down from 24% in 2018) ⁷. There was a marked increase in 2016 which coincided with the introduction of survey questions about New Psychoactive Substances and nitrous oxide use, but the trend was still upward when these substances were excluded from the total.

Of those secondary pupils that have used, half said they used drugs to get high, little changed on motivations stated back in 2011. Over the decade there has been a reduction the proportion of pupils saying they take drugs because their friends are doing it or because they were offered drugs.

• National surveys of adult drug use show more males use controlled drugs than females. For example, 9.6% of males used cannabis in the last year compared to 5.2% of females, and 11.8% of males had used any drug in the last year compared to 6.5% of females (England and Wales, year ending June 2022).
• Local adult survey data show no significant differences between the proportions of males and females saying they have never used cannabis, powder cocaine or nitrous oxide, but females are more likely to say they have never used ecstasy (Wakefield Adult Health Survey 2023).
• National survey data show no significant difference in prevalence of drug use between boys and girls (age 11 to 15 years). The Wakefield District School Health Survey 2022 found the same (Year 9 pupils).
• There are more adult males than females from Wakefield District in treatment. Of those in treatment for opiates in 2021/22, 1,125 were male and 440 were female. Of those in treatment for non-opiates only, 195 were male and 80 were female. The inequality was less for those in treatment for alcohol only - 390 were male and 275 were female.
• There is a similar inequality among young people in treatment for drug use. In 2021/22, 35 of those in treatment were male and 15 were female.
• Males were seven-times more likely than females to have been stopped and searched by the police for controlled drugs in 2022.

• National surveys of adult drug use show that younger adults are more likely to have taken a drug in the last year than older adults. Across England and Wales in the year ending June 2022, for example, proportions having taken a drug in the past year range from 23.3% of 20- to 24-year-olds to 2.2% of 55- to 59-year-olds. Differences in drug use by age are also evident in the Wakefield District Adult Health Survey (2023).
  National survey data of secondary school pupils shows proportions of pupils using drugs in the last year ranges from 3% of 11-year-olds to 24% of 15-year-olds (England 2021).
• The age profile of local people in treatment for opiate use is older than those in treatment for non-opiate use. In 2021/22, only 5% of people in treatment for opiates were aged under 30. By contrast, 51% of people in treatment for non-opiates only were aged under 30. The age profile of people in treatment for opiates has grown older over time - in 2009/10 35% of people in treatment for opiates were aged under 30. Of those in treatment for alcohol only in 2021/22, 32% were age 50 or over.
• People aged 18 to 24 years in Wakefield District are the most over-represented age group for controlled drugs stop and searches by the police (33% of stop and searches in 2022 but only 8% of the population aged 10+). Those aged 25-34 are also over-represented (28% of stop and searches in 2022 but only 16% of the population aged 10+).

• National survey data show drug use is lower among minority ethnic groups than among the White population. While reported drug use prevalence is highest among those from mixed ethnic background, particularly cannabis use, when the younger average age of this group is taken into account, their levels of drug use are similar to those in the White population. The lowest overall levels of drug use are reported by people from Asian backgrounds.
• People whose ethnicity is non-white are under-represented in the cohort of Wakefield District residents in treatment for substance use. The non-white ethnic group constitutes 7% of the population but only 2.6% of opiate users in treatment, 1.8% of non-opiate users in treatment and 1.5% of alcohol users in treatment (2021/22).
• Local survey of Year 9 pupils shows no difference by ethnicity in using drugs or being offered drugs.

• National survey data show that cannabis use in the last year is higher for people living with a disability (10.7%) than for people without (6.9%) (England and Wales year ending June 2022).
• 27% of Wakefield District adults presenting for drug use treatment in 2021/22 were living with a disability. Overall this is a similar proportion to the England average, although locally the numbers include a higher proportion of people with a mobility or gross motor disability than is seen nationally.

• The Wakefield District Adult Health Survey 2023 shows that 5% of people with low mental wellbeing use cannabis at least weekly, which is higher than people with good and high levels of mental wellbeing (Short Warwick Edinburgh Mental Wellbeing Scale).
• 67% of Wakefield District adults who entered drug treatment in 2021/22 were identified as having mental health treatment need, a similar proportion to the England average.
• 57% of Wakefield District young people who entered drug treatment in 2021/22 were identified as having mental health treatment need, a similar proportion to the England average.
• Among younger adults nationally (aged 18 to 22) ⁶ 21% say using drugs helps them deal with stress and 13% use drugs as means of self-medicating for an existing mental health condition.
• Among all adults, drug use is more common among people who have low levels of happiness, self-worth and life satisfaction, or high levels of anxiety.
• Among secondary school pupils in England, there has been a significant increase in pupils saying they take drugs to forget about their problems (up from 16% in 2011 to 27% in 2021, of those that use) ⁷.

• The Wakefield District School Health Survey 2022 found that 9% of pupils with special educational needs had used cannabis compared to 3% of pupils without special educational needs. And 8% of young carers said they had used cannabis, compared to 3% of their counterparts.

Preventing harmful drug use is central to a public health approach, which emphasises tackling the root causes of health and social harms and dependence and aims to reduce the number of people whose drug use has a long-term negative effect on their own and their family’s wellbeing. There are many factors associated with an increased risk of drug problems among young people and adults. These are often factors that lead to other adverse outcomes and risky behaviour, such as mental health problems, offending or risky sexual behaviour.

The prevention work delivered by Inspiring Recovery and Inspiring Futures includes,

• Outreach, prevention and early intervention to those at risk of drug and/or alcohol use.
• Specific prevention and early interventions to children and young people to reduce risky behaviours.
• Information, advice, guidance and support to family members and carers.
• Basic drug and alcohol awareness training, consultancy and the delivery of brief advice training to local organisations.
• Local awareness campaigns to promote the drug treatment service and to reduce the stigma around drug and alcohol services.
• Needle and syringe programmes for the provision, including safe disposal of needles, syringes and other injecting equipment, and advice on safer injecting.
• Providing Naxolone kits. Naloxone is a medicine that can rapidly reverse an opioid overdose.

Local schools are able to sign up to the West Yorkshire Police Pol-ed programme. This provides teachers with lesson plans and schemes of work for a range of topics related to relationships, keeping safe and understanding the law, including addiction. This is a free resource.

The district's 0 to 19 service supports children and young people who are thought to be at risk from their use of alcohol and drugs by providing information and advice on the risks and where appropriate referral to specialist support. The service has step up and step down pathways to young people's substance use services, including support where parental substance use is identified as a contributory factor.

The effectiveness of well-delivered, evidence-based treatment for drug use is well established. UK and international evidence consistently show that drug treatment – covering different types of drug problems, using different treatment interventions, and in different treatment settings – impacts positively on levels of drug use, offending, overdose risk and the spread of blood-borne viruses. For a significant proportion of those entering treatment, drug treatment results in long-term sustained abstinence ¹³.

The district-wide drugs and alcohol treatment service -

• accepts referrals from all sources; statutory, voluntary and community as well as self-referral.
• assesses all children and young people known to the Youth Offending Team (YOT) on statutory interventions.
• seek to identify the needs of family members, carers or extended family member of the individual who uses drugs.
• conducts a brief assessment for all eligible individuals who enter the system.
• undertakes a comprehensive assessment for all individuals receiving structured treatment.
• for children and young people, delivers specialist psychological interventions, specialist harm reduction, family work (to support families to manage the impact of substance use and enable them to better support the individual in the family), and pharmacological interventions.
• for adults, harm reduction interventions including advice on safely reducing or stopping using drugs, overdose prevention, sigh-posting to mutual aid groups, Hepatitis B vaccination and Hepatitis C screening), wound care and general health and wellbeing advice and information.
• delivers structured psychosocial interventions.
• delivers pharmacological interventions (including the use of Buvidal for clients with opioid dependence).
• organises supervised dispensing at pharmacies of opioid substitutes.
• develops Shared Care contracts and payments to GP’s for the delivery of Shared Care services.
• organises residential rehabilitation as an option for some individuals.

All individuals in treatment have a structured recovery plan and the Council supports social prescribing and advocates peer mentoring and volunteering as some of the many ways in which recovery support can be delivered.

• Get Connected and Out There Everywhere are aftercare services providing psychosocial support in the community supported by a team of trained volunteer peer mentors.

The commissioning locally of drug use prevention and treatment services is undertaken by Wakefield Council to fulfil its duties within the National Health Service Act 2006 (Section 2B). Priorities, emphasis and strategy are provided by the Government's drugs plan.

National drug misuse strategy - From Harm to Hope

The Government's 10-year drugs plan - From Harm to Hope was launched in 2022 and is comprised of three main strands: breaking drug supply chains; delivering a world-class treatment and recovery system; and achieving a generation shift in the demand for drugs. Combating illegal drugs and the harm they cause is a cross-cutting issue which needs action from a range of partners across all three priorities of the strategy to work collaboratively at a local level. Success is reliant on partners working together to understand their population and how drugs are causing harm in their area.

Locally, the Combating Drugs Partnership (CDP) has been established to reduce the harm caused by drugs and alcohol across the Wakefield District and to deliver From Harm to Hope. This is being achieved by creating a joint strategic approach on delivery across the three priorities of the strategy to ensure that the ambitions of the National Combating Drugs Outcome Framework are met. The CDP is accountable to central government for progress against this framework and future supporting metrics.

Project ADDER

Additional resources for treatment and enforcement were made available when Wakefield District joined the Project ADDER programme in July 2021.
The ADDER programme sought to ensure that more people get effective treatment, with enhanced treatment and recovery provision, including housing and employment support, and improved communication between treatment providers and courts, prisons, and hospitals. The programme ended in March 2023.