1. No category

Drug Statistics from the National Drug
Treatment Monitoring System
(NDTMS)
1 April 2012 to 31 March 2013
Published 6 November 2013
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
About Public Health England
Public Health England’s mission is to protect and improve the nation’s health and to
address inequalities through working with national and local government, the NHS,
industry and the voluntary and community sector. PHE is an operationally autonomous
executive agency of the Department of Health.
Public Health England
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Wellington House
London SE1 8UG
Tel: 020 7654 8000
http://www.gov.uk/phe
Twitter: @PHE_uk
Prepared by: Carol Lewis and Patrick Horgan
For queries relating to this document, please contact:
[email protected]
© Crown copyright 2013
You may re-use this information (excluding logos) free of charge in any format or
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concerned.
You can download this publication from www.gov.uk/phe
Published November 2013
PHE publications gateway number: 2013301
This document is available in other formats on request. Please email:
[email protected].
2
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
Contents
About Public Health England
2
Contents
3
Executive summary
4
1. Background
5
1.1
Drug treatment collection and reporting timeline
5
1.2
Policy context
6
1.3
Other sources of statistics about drugs
6
1.3.1 Prevalence of drug use
6
1.3.2 Young people
7
1.3.3 Criminal Justice statistics
7
1.3.4 International comparisons
7
1.3.5 Drug related deaths
7
1.4
Relevant web links
8
1.5
Comparability of data to previous reports
8
2. Abbreviations and definitions
9
2.1
Abbreviations
9
2.2
Definitions
9
3. Methodology
11
3.1
Data model
13
3.2
Methodological notes
13
4. Characteristics of clients
15
4.1
Age and gender of all clients
15
4.2
Ethnicity of all clients
16
4.3
Primary drug use
16
4.4
Source of referral into treatment (new presentations)
18
4.5
Age and primary substance (new presentations)
18
4.6
Injecting behaviour (new presentations)
19
4.7
Housing situation (new presentations)
19
5. Access to services
20
5.1
Waiting times (first and subsequent interventions)
20
5.2
Treatment pathways and interventions provided
20
5.3
Engagement
22
6. Treatment and recovery outcomes
23
6.1
Treatment exits
23
6.2
Treatment Outcomes Profile (TOP)
25
7. Trends over time
27
7.1
Trends in age group and primary drug group
27
7.2
Trends in club drug use
30
7.3
Trends in treatment exit reasons
31
7.4
Trends in numbers in treatment and numbers retained for at least 12 weeks or completing
treatment earlier
32
7.5
Trends in waiting times for first intervention
32
8. An eight year treatment population analysis
33
Appendix 1
36
Variable completeness
36
Report authors
37
References
37
3
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
Executive summary

Of the 193,575 clients aged 18 and over in treatment contact during 2012-13, 181,994 were in
treatment for 12 weeks or more or completed treatment free of dependency before 12 weeks
(94%)

29,025 (47%) of clients exiting treatment in 2012-13 completed treatment, defined as having
overcome their dependency; a further 8,019 (13%) were transferred for further treatment within
the community, while 6,602 (11%) were transferred into structured treatment while in custody

Of those opiate only clients with a six month review in 2012-13, 49% achieved abstinence from
illicit opiates and a further 23% were classified as reliably improved. A further 3% had
deteriorated

58% of crack only clients with a six month review in 2012-13 achieved abstinence from crack
cocaine and a further 7% were classified as reliably improved. 2% had deteriorated

Clients’ median age at their first point of contact in their latest treatment journey in 2012-13 was
35 and 73% of clients in treatment were male

Most clients were white British (83%), the next most common ethnicity was ‘white - other’ (4%).
No other ethnic groups accounted for more than 2% of clients

Most clients in contact with treatment were using opiates (80%). Cannabis was the primary drug
for 8% of clients and powder cocaine for 5% of clients.

The most common routes into treatment for clients starting treatment in 2012-13 were selfreferrals (42%) and referrals from the criminal justice system (28%). Onward referrals from other
drug services together accounted for 12%

85% of the clients starting new treatment journeys in 2012-13 were either in treatment for 12
weeks or more or completed treatment free of dependency before 12 weeks

Nearly all clients waited less than three weeks to commence treatment (98%)

Of the clients starting treatment (and where reported) just over half (56%) reported having never
injected with 17% currently injecting at time of presentation

Where reported, 9% of clients starting new journeys had no fixed abode on presenting for
treatment, and a further 15% of clients had other housing problems
4
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
1.
Background
This report presents information relating to drug treatment in England. The statistics are derived from data that has
been collected through the National Drug Treatment Monitoring System (NDTMS). The NDTMS collects activity
data from drug and alcohol treatment services so that:
·
the progress of individuals entering treatment may be monitored and their outcomes and recovery
assessed
·
trends and shifts in patterns of drug use and addiction can be monitored, to inform future planning locally
and nationally
·
service users’ journeys from addiction to recovery can be tracked
·
the impact of drug treatment as a component of the wider public health service may be measured
·
they can demonstrate their accountability to their service users, local commissioners and communities
·
costs can be benchmarked against data from comparable areas to show how efficiently they use
resources and how they are delivering value for money
Drug treatment activity has been collected nationally for nearly 25 years and has been routinely collected through
the National Drug Treatment Monitoring System (NDTMS) since April 2004. NDTMS is currently managed by
Public Health England (PHE).
The NDTMS has been reorganised over the years, bringing the definition of drug treatment recorded by the
system further into line with ‘Models of care for treatment of adult drug users’ (see
http://www.nta.nhs.uk/publications/documents/nta_modelsofcare_update_2006_moc3.pdf).
Since 2003-04 data collection has been consistently collected by treatment services, submitting a core data set of
their clients’ information as a database extract. The dataset and data collection methods have also changed. Code
sets for the core data set can be found in the NDTMS reference data document (see
http://www.nta.nhs.uk/areas/ndtms/core_data_set_page.aspx).
The NDTMS figures for England are collated by The National Drug Evidence Centre (NDEC) with those for
Scotland, Wales and Northern Ireland, into a UK return for use by the European Monitoring Centre for Drugs and
Drug Addiction (see http://www.emcdda.europa.eu/html.cfm/index190EN.html), and for the United Nations.
This statistical release covers England only. Information on drug treatment in Wales, Scotland and Northern
Ireland is also available:
http://www.wales.gov.uk/keypubstatisticsforwales/topicindex/topics.htm#public (Wales)
http://www.scotland.gov.uk/Publications/2005/12/e1295233/link (Scotland)
http://www.dhsspsni.gov.uk/index/stats_research/stats-pubs.htm (Northern Ireland)
NDEC is part of the Centre for Epidemiology, which is one of six centres in the Institute of Population Health,
University of Manchester.
1.1
Drug treatment collection and reporting timeline
1989 – March 2001 Regional Drug Misuse Database (RDMD) – statistics reported in six monthly bulletins by the
Department of Health from 1993 to 2001.
http://www.dh.gov.uk/en/Publicationsandstatistics/Statistics/StatisticalWorkAreas/Statisticalpublichealth/DH_40156
20
April 2001 – March 2004 National Drug Treatment Monitoring System (NDTMS) – statistics reported annually by
the Department of Health
April 2004 – March 2013 National Drug Treatment Monitoring System (NDTMS) – managed by the National
Treatment Agency (NTA) reporting statistics annually up to March 2012.
5
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
April 2013 to date National Drug Treatment Monitoring System (NDTMS) – managed by Public Health England
(PHE) reporting statistics annually from April 2012.
1.2
Policy context
Many of the analyses in each year’s annual report are intentionally identical to those published in previous reports
and are included to enable the reader to make a year on year comparison of statistics. New analyses have
periodically been added to the report since 2004, driven directly or indirectly by changes to the government’s drug
strategy. The policy context in relation to the published National Statistics from the NDTMS over that period has
been:
·
between 2004 and 2007, the primary data required to monitor the Public Service Agreement target was
the number of individuals in contact with treatment services, and followed from the then government’s
commitment to double this number between 1998 and 2008.
·
in 2007, the government published a Public Service Agreement (PSA), PSA Delivery Agreement 25:
Reduce the harm caused by alcohol and drugs. The performance indicator for the drug treatment element
of this PSA was the commitment to increase the number of problematic drug users in effective treatment.
·
in 2010, the coalition government published, ‘Drug Strategy 2010 – Reducing demand, restricting supply,
building recovery: supporting people to live a drug-free life’. The strategy is recovery-oriented and places
emphasis on a wider range of outcomes for individuals in drug treatment, including offending, employment
and housing.
Previous NDTMS annual publications can be found here: http://www.nta.nhs.uk/statistics.aspx
1.3
Other sources of statistics about drugs
1.3.1
Prevalence of drug use
An annual estimate of the prevalence of drug use is undertaken through the Crime Survey for England and Wales
(CSEW, formerly the British Crime Survey (BCS)). This section of the survey has been in place since 1996,
annually since 2001, and has tracked the prevalence of the use of different drugs over this time.
https://www.gov.uk/government/publications/drug-misuse-findings-from-the-2012-to-2013-csew
A second method for estimating the prevalence of crack cocaine and heroin use is produced for each local
authority area in England by Glasgow University. Estimates are available for 2006-07, 2008-09, 2009-10 and
2010-11. The estimates are produced through a mixture of capture-recapture and Multiple Indicator Methodology
(MIM), and rely on NDTMS data being matched against and/or analysed alongside Probation and Home Office
data sets. The data and further information are available here:
http://www.nta.nhs.uk/facts-prevalence.aspx
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Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
1.3.2
Young people
Information is also available relating to the prevalence of drug use among secondary school pupils aged 11 to 15
from the Smoking, Drinking and Drug Use Survey among young people in England. This is a survey carried out for
the NHS Information Centre by the National Centre for Social Research and the National Foundation for
Educational Research. The survey annually interviews school pupils, and has been in place since 2001. The data
and further information are available here;
https://catalogue.ic.nhs.uk/publications/public-health/surveys/smok-drin-drug-youn-peop-eng-2012/smok-drindrug-youn-peop-eng-2012-repo.pdf
The NDTMS collects data on drug and alcohol treatment for young people, and produces official statistics
bulletins, which can be found here:
http://www.nta.nhs.uk/statistics.aspx
It should be noted that young people’s treatment figures are not comparable with statistics relating to adult drug
treatment. This is because access to treatment for young people requires a ‘lower severity of drug use and
i
associated problems’ .
1.3.3
Criminal Justice statistics
The Ministry of Justice produce a quarterly statistics bulletin which provides details of individuals in custody and
under the supervision of the probation service. These can be found here:
http://www.justice.gov.uk/publications/statistics-and-data/prisons-and-probation/oms-quarterly.htm
Statistics are also produced by the Ministry of Justice relating to aspects of sentencing, including trends in
custody, sentences, fines and other disposals. These can be found here:
http://data.gov.uk/dataset/sentencing_statistics_england_and_wales
1.3.4
International comparisons
The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) publish an annual report that describes
and compares aspects of drug use and drug policy within European states, as well as providing detailed
comparative statistics. This can be found here:
http://www.emcdda.europa.eu/publications/annual-report/2012
The centre also produces a Treatment Demand Indicator (TDI), which is a collection of comparative statistics
relating to individuals seeking treatment. This can be found here:
http://www.emcdda.europa.eu/stats12#display:/stats12/tditab7a
1.3.5
Drug related deaths
The Office for National Statistics publish an annual summary of all deaths related to drug poisoning (involving both
legal and illegal drugs) and drug misuse (involving illegal drugs) in England and Wales. This can be found here:
http://www.ons.gov.uk/ons/rel/subnational-health3/deaths-related-to-drug-poisoning/2012/stb---deaths-related-todrug-poisoning-2012.html
7
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
1.4
Relevant web links
Monthly web-based NDTMS analyses
http://www.ndtms.net/
National Drug Evidence Centre (NDEC)
http://www.medicine.manchester.ac.uk/healthmethodology/research/ndec/
Public Health England
http://www.gov.uk/government/organisations/public-health-england
For further information and any queries about this release please contact
[email protected] – Head of Analysis, PHE
[email protected] – Information Manager, PHE
1.5
Comparability of data to previous reports
Since 1 November 2012, PHE made substantial changes to the core dataset with regards to the coding of
intervention type. Prior to this, intervention codes were restricted to the six broad categories: inpatient, residential
rehabilitation, prescribing, psychosocial, structured day programme and other structured treatment. These
categories did not allow the distinction to be easily made between the setting where the interventions were being
delivered and the interventions themselves.
Following consultations with clinicians, treatment providers and other key stakeholders a new method of recording
interventions types and setting separately was introduced alongside the ability for providers to record the nonstructured recovery support interventions that they were delivering. These changes will enable a better
understanding of the different interventions being provided nationally and in local areas which will in turn benefit
commissioning and service planning as well as influencing national policy setting.
As part of the changes in the coding of intervention type, from 1 November 2012 all registered treatment providers
are registered with a setting type. There are six settings; community, inpatient, residential, recovery house, prison
and primary care which have now been incorporated to PHEs regular reporting. Clients in a prison setting are not
reported on in this document. Definitions of these settings can be found in section 2.2 and the implementation
guide can be found here (http://www.nta.nhs.uk/uploads/guidetoimplementingcdsjv2.0.pdf). Intervention types
have been split in to three high-level categories; pharmacological interventions, psychosocial interventions and
recovery support interventions. Recovery support interventions are not reported on in the present report. Due to
these implemented changes, most reporting of interventions in this report is limited to those occurring on or before
st
31 October 2012. Therefore, the validity of comparing data to previous years, particularly in Tables 5.2.1, 5.2.2,
5.2.3, 6.1.2. and 6.1.3, is limited.
One result of the change in the method of recording types of intervention is that many clients had new modalities
opened (and old modalities closed) within the year to align with the new methodology, despite being in continuous
treatment. Within standard analyses these ‘replacement’ modalities would appear falsely as subsequent
interventions with associated waits. For this reason, subsequent waits in this report (table 5.1.1) are only shown
prior to 1 November 2012.
Responsible Statistician
Malcolm Roxburgh, Information Manager, PHE
8
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
2.
Abbreviations and definitions
2.1
Abbreviations
CARAT
Counselling, Assessment, Referral, Advice and Throughcare
CJS
Criminal Justice System
CQC
Care Quality Commission
DP
Drug partnership
DIP
Drug Interventions Programme
DRR
Drug Rehabilitation Requirement (formerly DTTO)
NDEC
National Drug Evidence Centre (University of Manchester)
NDTMS
National Drug Treatment Monitoring System
NTA
National Treatment Agency for Substance Misuse
PCT
Primary Care Trust
PHE
Public Health England
RDMD
Regional Drug Misuse Database
YP
Young persons
2.2
Definitions
Agency/provider
A provider of services for the treatment of alcohol misuse. They may be statutory
(i.e. NHS) or non-statutory (i.e. third sector, charitable).
Agency/provider code
A unique identifier for the treatment provider (agency) assigned by the regional
NDTMS centres - for example L0001.
Adjunctive drug use
Substances additional to the primary drug used by the client, NDTMS collects
secondary and tertiary substances.
Attributor
A concatenation of a client’s initials, date of birth and gender. This is used to
isolate records that relate to individual clients.
Client
A drug user presenting for treatment at a Tier 3 or 4 service. Records relating to
individual clients are isolated and linked based on the attributor and drug
partnership of residence.
Community setting
A structured drug and alcohol treatment setting where residence is not a condition
of engagement with the service. This will include treatment within community drug
and alcohol teams and day programmes (including rehabilitation programmes
where residence in a specified location is not a condition of entry).
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Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
Discharge date
This is usually the planned discharge date in a client’s treatment plan, where one
has been agreed. However, if a client's discharge was unplanned, then the date of
last face-to-face contact with the provider (agency) is used.
Drug partnership
Partnerships responsible for delivering the drug strategy at a local level (also
known as Drug and Alcohol Action Team, or DAAT).
Episode
A period of contact with a treatment provider (agency): from referral to discharge.
Episode of treatment
A set of interventions with a specific care plan. A client may attend one or more
interventions (or types) of treatment during the same episode of treatment. A
client may also have more than one episode in a year. A client is considered to
have been in contact during the year, and hence included in these results, if any
part of an episode occurs within the year. Where several episodes were collected
for an individual, attributes such as ethnicity, primary substance etc. are based on
the first valid data available for that individual.
In contact
Clients are counted as being in contact with treatment services if their date of
presentation (as indicated by triage), intervention start, intervention end or
discharge indicates that they have been in contact with an provider during the
year.
Inpatient setting
An in-patient unit provides assessment, stabilisation and/or assisted withdrawal
with 24-hour cover from a multidisciplinary clinical team who have had specialist
training in managing addictive behaviours. In addition, the clinical lead in such a
service comes from a consultant in addiction psychiatry or another substance
misuse medical specialist. The multi-disciplinary team may include psychologists,
nurses, occupational therapists, pharmacists and social workers. Inpatient units
are for those alcohol or drug users whose needs require supervision in a
controlled medical environment.
Intervention
A type of treatment, e.g. structured counselling, community prescribing etc.
First/subsequent intervention
'First intervention' refers to the first intervention that occurs in a treatment journey.
'Subsequent intervention' refers to interventions, within a treatment journey, that
occur after the first intervention.
Opiate
A group of drugs including heroin, methadone and buprenorphine
Presenting for treatment
The first face-to-face contact between a client and a treatment provider.
Primary care setting
Structured substance misuse treatment is provided in a primary care setting by a
general practitioner, often with a special interest in addiction treatment.
Primary Care Trust
A PCT was a type of National Health Service trust, part of the NHS in England.
PCTs were largely administrative bodies, responsible for commissioning primary,
community and secondary health services from providers..
Primary drug
The substance that brought the client into treatment at the point of triage/initial
assessment.
Recovery house setting
A recovery house is a residential living environment, in which integrated peersupport and/or integrated recovery support interventions are provided for
residents who were previously, or are currently, engaged in treatment to
overcome their drug and alcohol dependence. The residences can also be
referred to as dry-houses, third-stage accommodation or quasi-residential.
Referral date
The date the client was referred to the provider for this episode of treatment.
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Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
Residential rehab setting
A structured drug and alcohol treatment setting where residence is a condition of
receiving the intervention. A residential programme may also deliver an assisted
withdrawal programme.
Structured drug treatment
Structured drug treatment follows assessment and is delivered according to a
care plan, with clear goals, which are regularly reviewed with the client. It may
comprise a number of concurrent or sequential treatment interventions.
Tiers of treatment
Models of Care outlined a four-tier framework for drug treatment:
Tier 1 Non-substance misuse specific services requiring interface with drug and
alcohol treatment services
Tier 2 Open access drug and alcohol treatment services
Tier 3 Structured community-based drug treatment services
Tier 4 Residential and inpatient services for drug and alcohol misusers.
Treatment journey
A set of concurrent or serial treatment episodes linked together to describe a
period of treatment based on the clients’ attributors and DAAT of residence. This
can be within one provider or across a number of different providers.
Triage
An initial clinical risk assessment performed by a treatment provider. A triage
includes a brief assessment of the problem as well as an assessment of the
client’s readiness to engage with treatment, in order to inform a care plan.
Triage date
The date that the client made a first face-to-face presentation to a treatment
provider. This could be the date of triage/initial assessment though this may not
always be the case.
Waiting times
The period from the date a person is referred for a specific treatment intervention
and the date of the first appointment offered. Referral for a specific treatment
intervention typically occurs within the treatment provider, at or following
assessment.
Please note: Full operational definitions can be found in the NDTMS Core Data Set documents on
http://www.nta.nhs.uk/core-data-set.aspx.
3.
Methodology
NDTMS data are gathered from treatment providers by regional NDTMS teams and provided to PHE for data
analysis, processing and verification. Analysis is further verified by The National Drug Evidence Centre (NDEC) at
the University of Manchester. These analyses are then published by PHE and NDEC on behalf of The Department
of Health.
Those records that have the following are excluded from these analyses:








a missing provider code
an intervention recorded as Tier 1 or Tier 2
a missing date of birth
an age of less than 9 or greater than 75 years at triage
nicotine or alcohol recorded as the primary drug
an illogical chronological sequence of referral date, triage date and discharge date
a Drug Partnership of residence outside England
a record showing that an intervention commenced within a prison setting
11
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
Age – With the exception of section six (see below) the methodology used to calculate the age of clients is based
st
on the client’s age at the start of the financial year (1 April 2012) if their current treatment journey had
commenced before that point, otherwise their age at commencement of their current treatment journey is used.
Rounding and Suppressing - The percentages given in tables are rounded to the nearest per cent. Totals may
not add up to 100 due to rounding. Values less than five have been suppressed and associated figures have been
rounded to the nearest five in order to prevent possible deductive disclosure of personal information.
Individuals and Attributors – With the exception of section six (see below) all figures in this report are the
summation of the Partnership (DAAT) totals. The methodology used for this is described below.
The NDTMS collects limited attributable information on clients in structured drug treatment; these are First initial,
Surname initial, Date of Birth, Gender. These key fields are used to establish individuals along with the client’s
partnership of residence. Where there are two instances of the same attributor resident in two different drug
partnerships this is reported as two individuals, as this allows reporting of the progress and the accurate outcome
of each individual treatment journey.
Where there is more than one instance of the same attributor in one Partnership area this is then treated as one
individual with the multiple episodes utilised to construct the Treatment Journey of a client as defined below.
If a client has more than one treatment journey in the reporting period then for purposes of reporting the latest one
is always used.
This methodology was changed for the 2008-09 report and means that data in reports prior to this is not always
directly comparable. Section seven, which shows trends, uses revised data from earlier years to allow for
comparisons with 2008-09 onwards.
Reporting Substances - The NDTMS collects up to three substances recorded as problematic for the client by
the clinician at the point of triage. Due to the historic focus on those presenting for opiates and/or crack cocaine,
the methodology used for assigning drug groups was designed to help monitor presentations for these drugs.
Clients that have any opiate recorded in any of the three NDTMS substances within their treatment journey and
not crack cocaine will be reported under the group ‘opiates only’, although they may have other substances
recorded. Where a client has crack cocaine recorded within their treatment journey and not an opiate they will be
reported under ‘crack cocaine only’ although again they may have other substances recorded. If a client had both
opiate(s) and crack cocaine recorded within their journey they will be reported under ‘opiates and crack cocaine’.
If neither opiates nor crack cocaine are recorded within the client’s treatment journey, then the first substance in
the three NDTMS data items at presentation is reported in the report as the primary drug.
Length of time in prescribing for clients in continuous prescribing treatment – The 2012-13 data on
continuous prescribing follows the same methodology as 2010-11 which was slightly altered from previous
years. The change affects a very small number of cases where a provider has discharged a client but not
recorded the date that they completed their prescribing intervention. In these circumstances the client will now be
assumed to have completed prescribing on the date the provider discharged them.
Treatment Outcome Profiles - The TOP questionnaire was introduced to treatment systems in October 2007. It
consists of twenty questions about the client’s drug use, injecting behaviour, criminal activity and health and social
functioning. It is collected at the start of treatment, at six monthly intervals during treatment and at discharge from
treatment. Analysis for the 2012-13 annual report concentrates on change in presenting substances between the
start of treatment and the six month follow up period. The Reliable Change Index (RCI; Marsden et al, 2011) is
used to classify change into four categories: abstinence, reliably improved, unchanged and reliably deteriorated.
Attention is also paid to changes in employment, education and housing need.
12
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
Eight year treatment population analysis (section 8) – This section is an update of the six years of treatment
data published in the 2010-11 report. It is important to note that this section uses a different methodology to that
used elsewhere in the report - including section 5 where each year’s figures are calculated independently. As
such, direct comparisons cannot be made between these figures and those in other sections (or to those in
previous annual reports). Because many service users will have moved between areas in this time, the rule of
summing up individuals in each partnership area to get a national figure (used for calculating single year figures)
would lead to too much double counting and, therefore, over-reporting of numbers in treatment. As such,
individuals are defined by unique combinations of the variables First initial, Surname initial, Date of Birth, Gender.
Conversely, this will increase the instances where separate individuals who share the same set of attributable
variables have been incorrectly identified as a single person.
A further implication of the eight year analysis is that the age definition (see above) is not appropriate. Instead,
individuals have only been included if over 18 at their first recorded presentation to treatment.
3.1
Data model
The data model used by NDTMS is shown below.


Each client may receive one or more episodes of care at one or more treatment providers.
During each episode, the treatment provider may provide the client with one or more treatment interventions.
Client
Episode
Intervention
One to many
relationship
3.2
Methodological notes
Episodes are identified by unique combinations of attributor, provider attended and date of triage.
Clients are reported on the basis of their latest treatment journey within the year, with information pertinent to their
status at treatment start taken from the first episode within the treatment journey such as referral source. Other
data is taken across all the episodes in the treatment journey to make sure that all information as treatment
progresses, is captured.
Treatment journeys. The concept of the treatment journey is described in
http://www.nta.nhs.uk/publications/documents/nta_modelsofcare_update_2006_moc3.pdf. The operational
definition of a journey is that episodes are considered as linked elements of an ongoing treatment journey if they
are concurrent, or if 21 days or less elapses between discharge from one episode and starting the next. If a period
of more than 21 days elapses after discharge from a treatment episode, then the next episode is considered to be
the start of a new treatment journey.
The following diagram shows how episodes of care, occurring at three treatment agencies, are clustered into
treatment ’journeys’.
13
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
Black lines
indicate continuous episodes of care between the date a person starts the first modality and the
date they are discharged from the agency).
Green lines
episode.
Red lines
episode.
indicate periods of < 21 days between discharge and starting a treatment modality in another
indicate periods of > 21 days between discharge and starting a treatment modality in another
Provider A
1 journey, 1 episode
Provider A
1 journey, 2
episodes
Provider A
2 journeys, 2
episodes
Provider A
Provider B
2 journeys, 2
episodes
Provider A
Provider B
Provider C
1 journey, 3
episodes
Provider A
Provider B
1 journey, 3
episodes
Treatment Exits. Having now employed the treatment journey methodology for each client in contact with
treatment it is possible to report when the client has exited structured treatment completely. This is determined
when every episode in a treatment journey has a discharge date recorded, the latest discharge date in the
sequence is used to denote the date of treatment exit and the latest discharge reason is used to report why the
treatment journey ended.
14
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
4.
Characteristics of clients
During 2012-13 NDTMS reported 193,575 clients aged 18 and over in contact with structured treatment.
4.1
Age and gender of all clients
The age and gender of clients is reported in Table 4.1.1 and Figure 4.1.1 (see section 3 for the age methodology
used). Most treated persons were male (73%). The average (median) age of clients in treatment in 2012-13 was
35 years. Nationally, women had a younger average (median) age than men (34, compared to 36 for men). 55% of
men in treatment were aged 35 or over, compared to 49% of women, while 29% of women in treatment were aged
under 30, compared to 23% of men.
Table 4.1.1 Age and Gender of all clients in treatment 2012-13
Age
Female
n
18-24
Male
%
n
Persons
%
n
%
5,957
12
13,590
10
19,547
10
25-29
8,840
17
19,101
13
27,941
14
30-34
11,618
23
30,566
22
42,184
22
35-39
9,556
19
29,008
20
38,564
20
40-44
7,304
14
23,833
17
31,137
16
45-49
4,534
9
14,943
11
19,477
10
50-54
2,126
4
6,570
5
8,696
4
55-59
1,006
2
2,921
2
3,927
2
60+
513
1
1,589
1
2,102
1
Total
51,454
142,121
193,575
Figure 4.1.1 Age and gender distribution of all clients in contact with treatment 2012-13
35,000
Female n
Male n
30,000
25,000
20,000
15,000
10,000
5,000
0
18-24
25-29
30-34
35-39
40-44
45-49
50-54
15
55-59
60+
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
4.2
Ethnicity of all clients
Table 4.2.1 shows clients’ ethnicity. Most were white (88%) and the majority of these were white British. No other
ethnic groups accounted for more than 2% of clients
Table 4.2.1 Ethnicity of all clients in treatment 2012-13
Ethnicity
White British
White Irish
Other White
White & Black Caribbean
White & Black African
White & Asian
Other Mixed
Indian
Pakistani
Bangladeshi
Other Asian
Caribbean
African
Other Black
Chinese
Other
Not stated
Unknown
Total
Inconsistent/missing
Total inc inconsistent/missing
4.3
n
159,405
2,344
7,165
2,558
451
700
1,232
2,047
2,244
1,360
1,919
2,784
1,171
1,899
87
1,935
2,464
424
192,189
1,386
193,575
%
83
1
4
1
0
0
1
1
1
1
1
1
1
1
0
1
1
0
100
Primary drug use
Table 4.3.1 shows the distribution of primary drug use (the substance that brought the client into treatment at the
point of triage/ initial assessment) of clients aged 18 or over treated in 2012-13. In order to define primary drug, all
users of opiates and/or crack cocaine are identified in the first instance and reported as such. If a person is not
using opiates and/or crack cocaine they are reported by their primary drug (for further detail see section 3 under
‘Reporting substances’).
80% of clients were opiate users, of which more than a third reported adjunctive crack cocaine use. The majority of
remaining drug users were in treatment for problems with powder cocaine (5%), cannabis (8%) or crack cocaine
(2%), the latter excluding those also citing opiates. Among those aged 18 and over, opiate only users in treatment
had an average (median) age of 37, while adults in treatment for powder cocaine had a much lower average
(median) age of 29 and those in treatment for cannabis use had an average (median) age of 26. Adults in
treatment for benzodiazepines had the same median age as opiates only users (37).
16
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
Table 4.3.1 Primary drug use of all clients in treatment 2012-13
Drug Group
Opiates Only
Opiates & Crack
Crack Only
Benzodiazepines
Amphetamines (excl. Ecstasy)
Cocaine (excl. Crack)
Hallucinogens
Ecstasy
Cannabis
Solvent
Barbiturates
Major Tranquilisers
Anti-depressants
Other Drugs
Polydrug
Prescription Drugs
Misuse free/unknown
Total
Main Drug
n
93,434
61,620
4,509
1,146
3,874
10,009
577
188
16,321
101
8
25
22
761
4
816
160
193,575
%
48
32
2
1
2
5
0
0
8
0
0
0
0
0
0
0
0
100
Figure 4.3.1 Primary drug use of all clients in treatment 2012-13
Cocaine (excl.
Crack); 10,009 ;
5%
Cannabis;
16,321 ; 9%
Other drugs;
2,662 ; 1%
Amphetamines
(excl. Ecstasy);
3,874 ; 2%
Benzodiazepines
; 1,146 ; 1%
Opiates only ;
93,434 ; 48%
Opiates & Crack;
61,620 ; 32%
Crack only;
4,509 ; 2%
Opiates only
Crack only
Opiates & Crack
Benzodiazepines
Amphetamines (excl. Ecstasy)
Cocaine (excl. Crack)
Cannabis
Other drugs
17
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
4.4
Source of referral into treatment (new presentations)
Table 4.4.1 shows a breakdown of new presentations by source of referral. Information about source of referral
was provided for 68,523 (99%) new presentations to treatment in 2012-13. Of these, self-referrals (42%) were
most common. The second most common source of referrals came from the criminal justice system (28%). This
was made up of direct referrals through the Drug Interventions Programme (DIP)/arrest referral (12%), or via other
channels such as Prison, including Counselling, Assessment, Referral, Advice and Throughcare Services
(CARATS -9%), Drug Rehabilitation Requirements (DRR – 2%) and the Probation Service (5%). Referrals from
statutory drug services amounted to 5% of the total, while non-statutory drug services accounted for a further 7%.
GP referrals made up 7% of referrals.
Table 4.4.1 Source of referral into treatment, new presentations to treatment in 2012-13
Referral Source
A&E
Arrest Referral/DIP
CARAT/Prison
Community Care Assessment
Connexions
DRR
Drug Service Non-statutory
Drug Service Statutory
Education Service
Employment Service
GP
Probation
Psychiatry
Self
Social Services
Syringe Exchange
Other
Total
Inconsistent/missing
Total including inconsistent/missing
4.5
n
%
112
8,348
6,384
140
29
1,085
4,755
3,330
34
131
4,643
3,536
725
28,683
803
95
5,690
68,523
724
69,247
0
12
9
0
0
2
7
5
0
0
7
5
1
42
1
0
8
100
Age and primary substance (new presentations)
Table 4.5.1 shows a breakdown of persons entering drug treatment in 2012-13 by age group and primary
substance. Opiates and/ or crack users are identified first and then other clients entering treatment are assigned
according to their recorded primary drug. The proportion of opiate users was much lower in the 18-24 group
(29%) than any of the older age groups (between 59% and 75%). 44% of cannabis users, 27% of cocaine users
and 26% of other drug users were aged 18-24.
18
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
Table 4.5.1 Age and primary substance of new presentations to treatment in 2012-13
Opiates only
Opiates/Crack
Crack only
Cocaine
Cannabis
Other drugs
Misuse Free
Total
4.6
18-24
n
2,082
1,454
371
1,993
4,997
1,275
2
12,174
%
17
12
3
16
41
10
0
25-29
n
4,341
3,159
480
1,868
2,158
847
12,853
%
34
25
4
15
17
7
0
30-34
n
6,162
4,533
559
1,592
1,507
825
2
15,180
%
41
30
4
10
10
5
0
35-39
n
%
5,092
43
3,828
32
445
4
883
7
997
8
643
5
4
0
11,892
40+
n
7,388
4,907
938
1,036
1,621
1,252
6
17,148
%
43
29
5
6
9
7
0
Total
n
25,065
17,881
2,793
7,372
11,280
4,842
14
69,247
%
36
26
4
11
16
7
0
Injecting behaviour (new presentations)
Injecting status at presentation for treatment was recorded for 68,079 clients (98%) who entered treatment in
2012-13. Of these, 11,591 (17%) were currently injecting. A further 17,949 clients (26%) had previously injected
but were not doing so at the time of presenting for treatment. 38,199 (56%) clients had never injected.
Table 4.6.1 Injecting status of new presentations to treatment in 2012-13
Injecting Status
Currently Injecting
Previously Injecting
Never Injected
Declined to answer
Total
Inconsistent/missing
Total inc. missing / Inconsistent
4.7
n
11,591
17,949
38,199
340
68,079
1,168
69,247
%
17
26
56
0
100
Housing situation (new presentations)
The housing situation at presentation was reported for 67,812 (98%) of clients. Of these, 6,407 (9%) reported an
urgent housing problem (where they have no fixed abode), while a further 9,995 (15%) reported a housing problem
(such as staying with friends or family as a short term guest or residing at a short-term hostel). 50,156 (74%)
reported no housing problem.
Table 4.7.1 Housing situation of new presentations to treatment in 2012-13
Housing situation
Urgent problem
Housing problem
No problem
Other
Total
Not Stated/Missing
Total inc missing
n
%
6,407
9,995
50,156
1,254
67,812
1,435
69,247
9
15
74
2
100
The proportion of individuals with an urgent housing problem (9%) or other housing problem (15%) cannot be
directly compared with figures for individuals starting treatment with acute housing problems (18%) reported in
Table 6.2.2 as definitions used for these two methods for reporting housing issues are not the same.
19
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
5.
Access to services
5.1
Waiting times (first and subsequent interventions)
The table below shows a breakdown of waiting times under and over 3 weeks by first and subsequent intervention.
Of 68,407 first interventions beginning in 2012-13, 66,888 (98%) began within 3 weeks of referral. There were
24,388 subsequent interventions* (i.e. where a client who is already receiving a modality is referred to start
another type of treatment) beginning in 2012-13, of which 23,581 (97%) began within 3 weeks of referral. Overall
the average (mean) wait to commence treatment (first interventions only), was 5 days.
Table 5.1.1 Waiting times, first and subsequent waits, 2012-13
Intervention
Under 3
weeks (n)
%
Over 3
weeks (n)
%
Total
First intervention
66,888
98
1,519
2
68,407
Second intervention*
23,581
97
807
3
24,388
* Please note that, owing to changes in the dataset on 1 November 2012, only interventions starting prior to this date are
included in subsequent waits
5.2
Treatment pathways and interventions provided
As part of a treatment journey, a client may receive more than one intervention while being treated at a provider
and may attend more than one provider for subsequent interventions.
Prior to 1 Nov 2012 there were six structured treatment interventions, subsequently there were 63 potential
combinations of pathways Only the most common are reported here, with smaller numbers being grouped under
‘all other combinations’. Due to changes in the recording of interventions (see section 1.5 for more detail on this
change), Tables 5.2.1 and 5.2.2 only report on interventions that start on or before 31 October 2012 and are not
comparable to data from previous years.
Table 5.2.1 shows the treatment pathways for all clients with an intervention start date commencing on or before
31 October 2012 in 2012-13, reported by the combination of intervention types received. The largest group (51%)
were on the prescribing pathways (which should include basic psychosocial interventions delivered through regular
key working by case managers), while the most common combination of multiple intervention types is prescribing
and structured psychosocial (17%).
20
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
Table 5.2.1 Treatment pathways of clients in treatment 2012-13 with interventions commencing on or
before 31 October 2012
Pathway
Prescribing (including key working)
Structured Intervention
Psychosocial
Structured Day Programme (SDP)
Prescribing (inc. key working) and psychosocial
Prescribing (inc. key working) and Structured Day
Programme
Inpatient detoxification (IP)
Residential Rehabilitation (RR)
Prescribing (inc. key working) and IP
Prescribing (inc. key working) and RR
Prescribing(inc. key working), psychosocial/SDP and RR
Psychosocial/SDP and RR
Prescribing (inc. key working), SDP and psychosocial
All other combinations
No adult modality
Total
n
83,165
14,164
10,013
3,470
27,855
%
51
9
6
2
17
7,688
5
331
720
2,429
656
1,159
209
4,227
3,799
1,755
161,640
0
0
2
0
1
0
3
2
1
100%
To be included in Table 5.2.1, a valid intervention start date (occurring on or before 31 October 2012) must be
present.
Table 5.2.2 shows the number of clients who received each intervention in their latest treatment journey for clients
receiving interventions that commenced on or before 31 October 2012. Clients are counted once for each
intervention type they received in their latest journey, therefore percentage may sum to greater than 100%.
Table 5.2.3 provides information on interventions commenced after the changes to the core dataset on 1
November 2012 (see section 1.5 for more detail on this change), It shows the number of clients who received each
intervention by setting for interventions starting on or after 1 November 2012 based on the new intervention codes.
If a clients’ intervention features in Table 5.2.3, the same intervention (for interventions that can be directly
mapped between tables) is not featured in Table 5.2.2 to avoid double counting.
Table 5.2.2 Interventions received by clients in treatment 2012-13 commencing on or before 31 October
2012
Intervention
Prescribing (including key working)
Structured psychosocial intervention
Structured day programme
Residential rehabilitation
Inpatient detoxification
Structured intervention
n
62,031
14,134
18,589
2,363
6,532
54,842
21
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
Table 5.2.3: Interventions received by clients in treatment 2012-13, new interventions
Setting
Community
Inpatient Unit
Primary Care
Residential
Recovery House
Missing
Total number of individuals*
Intervention Type
Psychosocial
Prescribing
109,853
66,520
1,593
2,064
14,247
19014
1,583
462
127
17
2,011
1,768
125,652
86,392
Total number
of individuals*
122,131
2,204
25,613
1,611
132
2,021
140,629
* This is the total number of individuals receiving each intervention type and not a summation of the psychosocial and prescribing columns.
Data from Tables 5.2.2 and 5.2.3 can be summed where overlap exists to arrive at the total number of individuals
receiving each intervention in 2012-13. No overlap exists for structured day programmes or other structured
interventions thus the total number of clients can only be reported up until and including the 31 October 2012.
Data for these interventions is therefore not comparable to previous years. The totals for prescribing and
psychosocial interventions will appear higher than previous years as they can now be recorded instead of the
setting where they were taking place such as residential or within a structured day programme.
Table 5.2.4 gives a breakdown of clients receiving prescribing by the length of time that they have been receiving
this intervention. 37,326 (25%) had been receiving prescribing for five or more years, while 50,104 (34%) had
been receiving prescribing for less than 12 months. There is a note on this table in section 3.
Table 5.2.4 Length of time in prescribing for clients in continuous prescribing treatment 2012-13
n
Less than 12 months
1 to 2 Years
2 to 3 Years
3 to 4 Years
4 to 5 Years
5+ years
Total
5.3
50,104
21,375
15,823
12,611
11,184
37,326
148,423
%
34
14
11
8
8
25
100
Engagement
Of all clients 18 and over in contact with treatment services during 2012-13, 181,994 (94%) were either retained
for more than 12 weeks, or if leaving treatment before 12 weeks, were free of dependency. Of the 69,247 clients
starting new treatment journeys during 2012-13, 58,665 (85%) were either retained for more than 12 weeks, or if
leaving treatment before 12 weeks, were free of dependency.
22
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
6.
Treatment and recovery outcomes
6.1
Treatment exits
Table 6.1.1 shows the reasons for clients exiting treatment in 2012-13. There were 61,899 clients aged 18 and
over who left treatment during the year and were not in treatment on 31st March 2013. Of these, 29,025 (47%)
were discharged as Treatment Completed, defined as those completing treatment free of their drug of dependency
and not using either heroin or crack cocaine. On average (mean), clients who completed treatment did so after 543
days (just less than 18 months). A further 8,019 were transferred for further treatment within the community, while
6,602 were transferred into appropriate treatment while in custody.
st
Table 6.1.1 Treatment exit reasons for individuals not retained in treatment on 31 March 2013
Treatment exit reason
Treatment completed free of dependency (no drug use)
Treatment completed free of dependency
Treatment completed subtotal
Transferred - not in custody
Transferred - in custody
Referred on (old coding)
Dropped out/left
Prison
Other
Treatment declined
Treatment withdrawn
Moved away
Died
Not known
No appropriate treatment
Total individuals exited
n
%
21,138
34
7,887
13
29,025
47
8,019
13
6,602
11
0
0
14,562
24
792
1
0
0
1,117
2
578
1
0
0
1,204
2
0
0
0
0
61,899
100
Table 6.1.2 shows the treatment pathways of the 16,440 clients who completed treatment free of dependency
between 1 April 2012 and 31 October 2012. The pathways are displayed below in two parts; the upper part of the
table shows the numbers of clients who received only one type of treatment during their journey, whereas the
lower part shows the numbers receiving multiple interventions. Young person specific interventions are presented
separately. Although the data refers to adults in drug treatment, there are some clients who received young person
specific interventions that were commenced as a young person aged less than 18. All interventions listed in Table
6.1.2 are exits with intervention start dates and discharge dates occurring on or before 31 October 2012. Due to
the changes to the coding of interventions, individuals completing treatment free of dependency after 31 October
2012 are not included in Table 6.1.2. (See section 1.5 for more detail on this change). Of the 16,440 clients
completing treatment free of dependency within these timescales, 2,918 (18%) received multiple interventions.
6,222 (38%) had received prescribing, either on its own (which includes a key working element) or together with
another structured intervention. The figures include a number of clients who started young people’s interventions
as 17 year-olds but completed as adults.
23
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
Table 6.1.2 Pathway for clients completing treatment free of dependency between 1 April 2012 and 31
October 2012
Pathway
n
%
SINGLE INTERVENTION
Structured intervention
Prescribing (inc. key working)
Psychosocial
Structured Day Programme (SDP)
Residential rehab (RR)
Inpatient detoxification (IP)
Young Person intervention
Sub-total of individuals
MULTIPLE INTERVENTIONS
4,220
3,750
3,318
1,157
246
176
655
13,522
26
23
20
7
1
1
4
82
Prescribing-plus
Psychosocial-plus
Structured Day Programme (SDP)-plus
Rehab (RR)-plus
Inpatient detoxification (IP)-plus
Sub-total of individuals
All clients completing treatment
2,472
2,084
1,053
358
594
2,918
16,440
15
13
6
2
4
18
100
Table 6.1.3 shows the last intervention (or combination if more than one) that each of the 16,440 clients who
completed treatment as described above received prior to being discharged. 4,871 individuals (30%) were
receiving (other) Structured Intervention as the last component of their treatment journey.
Table 6.1.3 Last modalities received for clients completing treatment free of dependency between 1 April
2012 and 31 October 2012
Last modality (or modalities)
Structured intervention
Prescribing (inc. key working)
Psychosocial
Structured Day Programme (SDP)
Prescribing (inc. key working), Psychosocial
Prescribing (inc. key working), Structured Intervention
Rehab (RR)
Inpatient detoxification (IP)
Psychosocial, Structured Intervention
SDP, Structured Intervention
Psychosocial, SDP
Prescribing (inc. key working), SDP
Young Person Modality
Other
All clients completing treatment
n
4,871
4,057
3,283
1,170
738
575
391
168
215
83
110
42
655
82
16,440
24
%
30
25
20
7
4
3
2
1
1
1
1
0
4
0
100
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
6.2
Treatment Outcomes Profile (TOP)
Introduction
The Treatment Outcomes Profile (TOP) is a clinical tool that enables clinicians and drug workers to keep track of
the progress of individuals through their treatment journey. It measures drug use and gives an early indication
about clients’ progress in overcoming problems with work, education or housing through a set of 20 questions.
Comparisons of TOP responses given at the start of treatment and at six month review are presented in this
report.
This report includes an analysis of all TOP review data received in 2012-13 that complies with the TOP reporting
protocols and for which there is also corresponding treatment start TOP information. The reporting protocols
stipulate that an individual can have a review TOP completed between 29 and 182 days following their initial
assessment. In principle, there were 94,584 individuals who could have had a TOP review during 2012-13
according to this protocol. However, in practice, 61,924 (65%) of these had both received a review and had
corresponding TOP data at treatment start (because the data set used for this report was taken before many of
those starting treatment toward the end of the period would have received their six month review, this does not
represent the full level of review compliance.) Of the clients with both start and review data, 50,714 had reviews
which took place in 2012-13 and are therefore included in the analysis here.
Methods
The TOP instrument uses a measure of the number of days in the last 28 on which an individual used drugs to
quantify change. The analysis of the data here uses a mechanism for categorisation of degree of change known
as the Reliable Change Index (RCI). This is a statistical approach that classifies individuals into one of four
categories: abstinent, improved, unchanged and deteriorated. This is based on the application of the methodology
ii
advanced by Jacobson and Truax (1991) and verified for use in the substance misuse field by Marsden et al
iii
(2011) . For an explanation of the reliable change index, see section 3.
Key Findings
Key findings from the data are that illicit opiate use fell by a mean of 15.1 days, in the opiate-only group compared
with 12.2 days in the opiates & crack group. The opiates-only drug group achieved greater abstinence rates from
illicit opiates than the opiates & crack drug group (49% compared to 39%). Slight differences exist between those
classified as reliably improved, with the opiates-only group having 23% improved and the opiates & crack group
having 24% classified as such. 3% of the opiates-only group reliably deteriorated compared with 4% of the opiates
& crack drug group.
Table 6.2.1 shows changes in drug use between start and review for each client’s primary presenting substance
by drug group (see section 3 for the methodology used to assign drug groups) for clients who reported using their
primary drug on at least one day in the 28 prior to starting treatment. For clients in the opiates & crack group,
change has been reported for both of these substances.
The mean days of crack use fell by 6.8 days in the crack-only drug group and 7.1 days in the opiates & crack
group. A greater percentage of the crack-only drug group were abstinent from crack at six months compared with
the opiates & crack drug group (58% and 50%), while the crack-only group had less people classified as reliably
improved.
For primary cocaine powder clients, 75% were classified as abstinent or improved at review. 65% of primary
amphetamine clients were abstinent or improved and 53% of cannabis clients were abstinent or improved.
25
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
Table 6.2.1 Change in use of primary cited substance and adjunctive alcohol use for clients with a six
month review TOP in the year who reported using at start TOP
Start of Treatment
Reviewed Average
clients
days of
using at
use at
start
start
Drug group
Review
Abstinent
Improved
Unchanged
Deteriorated
Average
days of
use at
review
n
mean
%
%
%
%
mean
Opiates only
12,611
20.99
49%
23%
25%
3%
5.91
Opiates and crack
9,982
19.55
39%
24%
32%
4%
7.39
Crack only
1,159
10.53
58%
7%
33%
2%
3.75
Opiates and crack
8,848
12.27
50%
12%
33%
5%
5.18
3,903
9.21
64%
11%
24%
1%
2.21
950
15.82
53%
12%
33%
2%
6.38
6,832
22.19
33%
20%
45%
3%
11.67
10,636
15.22
30%
14%
49%
7%
9.96
Opiates use
Crack use
Cocaine use
Cocaine
Amphetamine use
Amphetamines
Cannabis use
Cannabis
Alcohol (adjunctive) use
Alcohol
Table 6.2.2 shows the treatment outcomes for employment, education and housing. At the start of treatment, 18%
of clients were employed and were engaged in work for an average of 18 days out of the 28 days preceding the
start of treatment. At the six month review, 21% of clients were employed while the average number of days
worked in the 28 prior to review was, again, 18.
In terms of accessing education, 3% of clients were enrolled in a course at the start of treatment, spending on
average 10 days studying in the month preceding treatment. At the six month review, the percentage of the cohort
in education had increased to 4%, while the average number of days a client studied for was 9 in the preceding 28
days.
An acute housing problem (i.e. no fixed abode) was recorded for 18% of clients at the start of treatment and this
fell to 12% at six month follow up. 8% of clients reported a housing risk (i.e. risk of eviction) at the start of
treatment and 5% reported this problem at review. Overall, 19% of clients reported either an acute housing
problem or had a housing risk at the start of treatment. This was reported by 13% of clients by review.
Table 6.2.2 Change in employment, education and housing status at review
Employment
n
Baseline work
Review work
49,558
Education
Baseline education
Review education
49,364
Housing issues
49,538
49,317
49,271
Acute housing problem
Housing risk
Any housing problem
26
Employed %
18%
21%
Mean days
18
18
In education %
3%
4%
Mean days
10
9
Baseline %
18%
8%
19%
Review %
12%
5%
13%
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
7.
Trends over time
7.1
Trends in age group and primary drug group
Table 7.1.1 shows trends in age group and drug group among new presentations from 2005-06 to 2012-13. The
number of newly presenting opiates users has fallen from 59,642 in 2005-06 to 42,946; considered as a proportion
of newly presenting adults this represents a decline from 72% in 2005-06 to 62% in 2012-13. This is largely as a
result of a sharp decrease in the number of newly presenting opiates users aged 18-24, from 11,309 in 2005-06 to
3,536 in 2012-13 – among newly presenting clients in this age group, the proportion who were opiates users
dropped from 61% in 2005-06 to 29% in 2012-13. The number of clients in this age group who present using
cannabis has increased from 3,328 in 2005-06 to 4,997 in 2012-13 – correspondingly, the proportion of new
presentations aged 18-24 who use cannabis has increased from 18% to 41% since 2005-06. Newly presenting
clients aged 18-24 using cocaine dropped slightly to 1,993 continuing a downward trend from 3,005 in 2008-09.
Despite the substantial drop in new presentations to treatment in 2012-13, the proportion of new clients over 40
increased slightly to 25%, continuing a trend going back to 2005-06 when this age group represented 15% of all
those newly presenting to treatment.
Table 7.1.1 Trends in age group and primary drug group among new presentations to treatment
2005-06
2006-07
2007-08
2008-09
Drug Group
Opiates only
Opiates/crack
Crack only
Cocaine
Cannabis
Other/unknown
Misuse free
Total
Opiates only
Opiates/crack
Crack only
Cocaine
Cannabis
Other/unknown
Misuse free
Total
18 - 24
n
%
7,449
40
3,860
21
1,011
5
1,586
9
3,328
18
1,163
6
103
1
18,500 100
5,837
35
3,481
21
1,059
6
2,096
12
3,233
19
1,013
6
149
1
16,868 100
25 - 29
n
%
10,036
50
5,384
27
1,015
5
1,193
6
1,367
7
918
5
72
0
19,985 100
8,963
48
5,219
28
999
5
1,385
7
1,244
7
823
4
133
1
18,766 100
30 - 34
n
%
9,173
50
4,949
27
946
5
1,029
6
1,104
6
1,046
6
82
0
18,329 100
8,182
47
5,161
30
947
5
1,107
6
978
6
778
5
127
1
17,280 100
35 - 39
n
%
6,238
46
3,766
28
815
6
718
5
878
7
950
7
78
1
13,443 100
5,952
45
4,059
31
758
6
801
6
834
6
785
6
119
1
13,308 100
40+
n
%
5,821
46
2,966
23
859
7
562
4
902
7
1,306
10
262
2
12,678 100
6,174
44
3,667
26
1,038
7
712
5
1,012
7
1,112
8
285
2
14,000 100
Total
n
%
38,717
47
20,925
25
4,646
6
5,088
6
7,579
9
5,383
6
597
1
82,935 100
35,108
44
21,587
27
4,801
6
6,101
8
7,301
9
4,511
6
813
1
80,222 100
Opiates only
Opiates/crack
Crack only
Cocaine
Cannabis
Other/unknown
Misuse free
Total
Opiates only
Opiates/crack
Crack only
Cocaine
Cannabis
Other/unknown
Misuse free
Total
4,833
3,684
1,115
2,691
3,549
1,159
68
17,099
4,355
3,335
1,046
3,005
3,749
975
58
16,523
7,779
6,064
1,064
1,834
1,429
955
53
19,178
7,632
6,151
1,103
2,106
1,481
777
49
19,299
7,488
5,561
971
1,301
1,097
883
57
17,358
7,570
5,943
886
1,438
1,028
815
41
17,721
5,686
4,605
769
927
868
831
50
13,736
6,011
4,938
807
987
817
767
35
14,362
6,207
4,411
1,092
834
1,078
1,273
69
14,964
6,890
5,093
1,203
986
1,112
1,236
95
16,615
31,993
24,325
5,011
7,587
8,021
5,101
297
82,335
32,458
25,460
5,045
8,522
8,187
4,570
278
84,520
28
22
7
16
21
7
0
100
26
20
6
18
23
6
0
100
41
32
6
10
7
5
0
100
40
32
6
11
8
4
0
100
27
43
32
6
7
6
5
0
100
43
34
5
8
6
5
0
100
41
34
6
7
6
6
0
100
42
34
6
7
6
5
0
100
41
29
7
6
7
9
0
100
41
31
7
6
7
7
1
100
39
30
6
9
10
6
0
100
38
30
6
10
10
5
0
100
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
2009-10
2010-11
2011-12
2012-13
Opiates only
Opiates/crack
Crack only
Cocaine
Cannabis
Other/unknown
Misuse free
Total
4,203
2,568
656
2,313
4,417
1056
27
15,240
28
17
4
15
29
7
0
100
7,184
4,832
706
1,868
1,670
732
18
17,010
42
28
4
11
10
4
0
100
7,694
5,120
640
1,295
1,157
728
18
16,652
46
31
4
8
7
4
0
100
6,224
4,170
634
843
867
710
24
13,472
46
31
5
6
6
5
0
100
7,684
4,651
1,050
985
1,302
1,173
36
16,881
46
28
6
6
8
7
0
100
32,989
21,341
3,686
7,304
9,413
4,399
123
79,255
42
27
5
9
12
6
0
100
Opiates only
Opiates/crack
Crack only
Cocaine
Cannabis
Other/unknown
Misuse free
3,253
2,279
576
2,132
4,493
1,269
7
23
16
4
15
32
9
0
5,639
4,307
694
1,724
1,754
812
11
38
29
5
12
12
5
0
6,906
5,133
677
1,264
1,166
761
15
43
32
4
8
7
4
0
5,740
4,215
564
831
847
700
8
44
33
4
6
7
5
0
7,259
4,615
1,076
923
1,248
1,115
15
45
28
7
6
8
7
0
28,797
20,549
3,587
6,874
9,508
4,657
56
39
28
5
9
13
6
0
Total
14,009
100
14,941
100
15,922
100
12,905
100
16,251
100
74,028
100
Opiates only
Opiates/crack
Crack only
Cocaine
Cannabis
Other/unknown
Misuse free
Total
Opiates only
Opiates/crack
Crack only
Cocaine
Cannabis
Other
Misuse Free
2,534
1,734
422
2,101
4,741
1,115
8
12,655
2,082
1,454
371
1,993
4,997
1,275
2
20
14
3
17
37
9
0
100
17
12
3
16
41
10
0
4,891
3,576
535
1,815
1,994
825
5
13,641
4,341
3,159
480
1,868
2,158
847
0
36
26
4
13
15
6
0
100
34
25
4
15
17
7
0
6,300
4,601
636
1,302
1,375
784
6
15,004
6,162
4,533
559
1,592
1,507
825
2
42
31
4
9
9
5
0
100
41
30
4
10
10
5
0
5,169
3,734
543
880
952
666
3
11,947
5,092
3,828
445
883
997
643
4
43
31
5
7
8
6
0
100
43
32
4
7
8
5
0
7,053
4,474
1,008
961
1,482
1,203
6
16,187
7,388
4,907
938
1,036
1,621
1,252
6
44
28
6
6
9
7
0
100
43
29
5
6
9
7
0
25,947
18,119
3,144
7,059
10,544
4,593
28
69,434
25,065
17,881
2,793
7,372
11,280
4,842
14
37
26
5
10
15
7
0
100
36
26
4
11
16
7
0
Total
12,174
100
12,853
100
15,180
100
11,892
100
17,148
100
69,247
100
Table 7.1.2 shows trends in age group and drug group among the entire treatment population from 2005-06 to
2012-13. This shows that for five years the number of adults being treated for opiates use increased from 139,544
in 2005-06 to 167,200 in 2009-10, but has dropped over the last two years to 155,054 in 2012-13, although the
proportion of opiate users in treatment has remained relatively steady, around 80%.
This relatively steady picture is maintained across the age groups apart from the 18-24 age group, where the
number of opiates users fell from 22,581 in 2005-06 to 7,460 in 2012-13 (a drop from 69% of those in treatment in
this age group in 2005-06 to 38% in 2012-13). Over the eight-year period, the number of clients aged 18-24 in
treatment has fallen from 32,948 to 19,547, while the number of clients aged 40 or over has increased from 32,406
to 65,339. This means that in 2012-13 10% of the adult treatment population were aged 18-24 and 34% were aged
40 or over, compared to 19% aged 18-24 and 18% aged 40 or over in 2005-06.
Table 7.1.2 Trends in age group and primary drug group among entire treatment population
2005-06
Drug Group
Opiates only
Opiates/crack
Crack only
Cocaine
Cannabis
Other/unknown
Misuse free
Total
18 - 24
n
%
15,408
47
7,173
22
1,546
5
2,072
6
4,735
14
1,844
6
170
1
32,948 100
25 - 29
n
%
22,990
57
10,380
26
1,549
4
1,691
4
1,910
5
1,624
4
125
0
40,269 100
30 - 34
n
%
22,725
57
10,276
26
1,599
4
1,489
4
1,654
4
1,866
5
131
0
39,740 100
28
35 - 39
n
%
17,031
56
7,874
26
1,346
4
1,053
3
1,325
4
1,729
6
148
0
30,506 100
40+
n
%
19,099
59
6,588
20
1,397
4
849
3
1,481
5
2,583
8
409
1
32,406 100
Total
n
97,253
42,291
7,437
7,154
11,105
9,646
983
175,869
%
55
24
4
4
6
5
1
100
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
2006-07
2007-08
2008-09
2009-10
2010-11
2011-12
2012-13
Opiates only
Opiates/crack
Crack only
Cocaine
Cannabis
Other/unknown
Misuse free
Total
13,397
7,480
1,702
2,883
5,501
1,845
173
32,981
41
23
5
9
17
6
1
100
23,434
12,271
1,728
2,105
2,093
1,612
136
43,379
54
28
4
5
5
4
0
100
23,847
12,443
1,745
1,696
1,760
1,689
139
43,319
55
29
4
4
4
4
0
100
18,601
10,186
1,462
1,274
1,488
1,717
140
34,868
53
29
4
4
4
5
0
100
22,370
9,221
1,865
1,155
1,815
2,851
349
39,626
56
23
5
3
5
7
1
100
101,649
51,601
8,502
9,113
12,657
9,714
937
194,173
52
27
4
5
7
5
0
100
Opiates only
Opiates/crack
Crack only
Cocaine
Cannabis
Other/unknown
Misuse free
Total
Opiates only
Opiates/crack
Crack only
Cocaine
Cannabis
Other/unknown
Misuse free
Total
Opiates only
Opiates/crack
Crack only
Cocaine
Cannabis
Other/unknown
Misuse free
Total
10,848
7,481
1,679
3,631
5,717
1,765
118
31,239
9,317
7,160
1,584
4,187
6,205
1,640
117
30,210
8,407
5,890
1,104
3,397
6,665
1,548
60
27,071
35
24
5
12
18
6
0
100
31
24
5
14
21
5
0
100
31
22
4
13
25
6
0
100
21,966
14,009
1,730
2,575
2,199
1,527
87
44,093
20,839
15,078
1,728
2,989
2,321
1,468
85
44,508
19,324
13,466
1,244
2,705
2,505
1,200
41
40,485
50
32
4
6
5
3
0
100
47
34
4
7
5
3
0
100
48
33
3
7
6
3
0
100
23,170
13,995
1,612
1,921
1,730
1,510
105
44,043
23,262
15,389
1,546
2,128
1,672
1,449
72
45,518
23,632
15,258
1,149
1,912
1,733
1,242
38
44,964
53
32
4
4
4
3
0
100
51
34
3
5
4
3
0
100
53
34
3
4
4
3
0
100
19,054
11,921
1,406
1,424
1,431
1,500
104
36,840
20,203
13,687
1,398
1,546
1,390
1,501
67
39,792
21,017
13,590
1,133
1,344
1,321
1,270
44
39,719
52
32
4
4
4
4
0
100
51
34
4
4
3
4
0
100
53
34
3
3
3
3
0
100
24,634
11,910
1,981
1,294
1,928
2,632
211
44,590
27,454
14,867
2,161
1,551
1,937
2,634
183
50,787
30,218
16,398
1,930
1,555
2,085
2,386
78
54,650
55
27
4
3
4
6
0
100
54
29
4
3
4
5
0
100
55
30
4
3
4
4
0
100
99,672
59,316
8,408
10,845
13,005
8,934
625
200,805
101,075
66,181
8,417
12,401
13,525
8,692
524
210,815
102,598
64,602
6,560
10,913
14,309
7,646
261
206,889
50
30
4
5
6
4
0
100
48
31
4
6
6
4
0
100
50
31
3
5
7
4
0
100
Opiates only
Opiates/crack
Crack only
Cocaine
Cannabis
Other/unknown
Misuse free
7,021
5,027
889
2,941
6,852
1,803
36
29
20
4
12
28
7
0
16,517
12,180
1,069
2,439
2,556
1,228
20
46
34
3
7
7
3
0
22,958
15,781
1,122
1,822
1,751
1,248
25
51
35
3
4
4
3
0
21,419
14,385
964
1,229
1,323
1,228
23
53
35
2
3
3
3
0
32,518
18,415
1,874
1,460
2,065
2,246
39
55
31
3
2
4
4
0
100,433
65,788
5,918
9,891
14,547
7,753
143
49
32
3
5
7
4
0
Total
24,569
100
36,009
100
44,707
100
40,571
100
58,617
100
204,473
100
Opiates only
Opiates/crack
Crack only
Cocaine
Cannabis
Other/unknown
Misuse free
Total
Opiates only
Opiates &
Crack
Crack only
Cocaine
Cannabis
Other/unknown
Misuse Free
Total
5,425
3,903
657
2,788
6,884
1,615
18
21,290
4,359
25
18
3
13
32
8
0
100
22
13,800
10,228
864
2,400
2,758
1,232
7
31,289
11,782
44
33
3
8
9
4
0
100
42
21,872
15,273
1,008
1,792
1,948
1,243
15
43,151
20,938
51
35
2
4
5
3
0
100
50
21,107
13,903
878
1,240
1,387
1,163
7
39,685
20,314
53
35
2
3
3
3
0
100
53
34,139
19,892
1,722
1,420
2,217
2,289
16
61,695
36,041
55
32
3
2
4
4
0
100
55
96,343
63,199
5,129
9,640
15,194
7,542
63
197,110
93,434
49
32
3
5
8
4
0
100
48
3,101
16
8,643
31
14,825
35
13,675
35
21,376
33
61,620
32
535
2,643
7,178
1,723
8
19,547
3
14
37
9
0
100
727
2,482
3,074
1,230
3
27,941
3
9
11
4
0
100
890
2,098
2,135
1,291
7
42,184
2
5
5
3
0
100
753
1,267
1,471
1,079
5
38,564
2
3
4
3
0
100
1,604
1,519
2,463
2,322
14
65,339
2
2
4
4
0
100
4,509
10,009
16,321
7,645
37
193,575
2
5
8
4
0
100
29
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
7.2
Trends in club drug use
Table 7.2.1 reports the number of clients aged 18 or over presenting to treatment in each of the years 2005-06 to
2012-13, where the person reported using one or more club drug(s). For the report ‘Club Drugs: Emerging Trends
and Risks’ (http://www.nta.nhs.uk/uploads/clubdrugsreport2012[0].pdf), a ‘club drug user’ was defined as a person
citing any of the following substances, either as a primary or adjunctive drug: GHB/GBL, ketamine, ecstasy,
methamphetamine or mephedrone. This report extends the analysis carried out for that report, which covered
2005-06 through to 2011-12, using data from 2012-13.
The number of clients presenting to treatment for a club drug increased from 2,675 in 2011-12 to 3,536 in 2012-13.
This was an increase from 4% of those presenting to treatment in 2011-12 to 5% in 2012-13. Increases in
numbers presenting to treatment were observed for all five substances: the most significant was an 81% increase
in mephedrone presentations, from 900 in 2011-12 to 1,630 in 2012-13. Numbers presenting to treatment citing
methamphetamine increased by 79% from 116 in 2011-12 to 208 in 2012-13, but still make up just 0.3% of all
presentations to treatment.
Table 7.2.1 Trends in numbers presenting to treatment citing club drug use
Substance
GHB/GBL
2005-06
18
2006-07
46
2007-08
66
2008-09
80
2009-10
142
2010-11
135
2011-12
190
2012-13
231
Ketamine
114
235
392
558
675
845
751
868
Ecstasy
1,872
2,138
2,102
1,694
1,467
1,067
1,018
1,089
Methamphetamine
22
27
52
42
75
78
116
208
Mephedrone*
-
-
-
-
-
839
900
1,630
Any club drug cited
Percentage of all new
presentations citing a
club drug
1,991
2,371
2,503
2,246
2,280
2,692
2,675
3,536
2
3
3
3
3
4
4
5
*A code for mephedrone was added to the NDTMS Core Data Set in 2010-11. Any clients reporting mephedrone prior to this
are counted in the ‘Any club drug cited’ total but no separate total is given for mephedrone.
30
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
7.3
Trends in treatment exit reasons
Table 7.3.1 reports treatment exit reasons for clients in the years 2005-06 to 2012-13. In 2009 a new discharge
coding system was introduced which clarified the coding of referrals within the treatment system, and tightened the
way “treatment completed” was recorded. For further details see section 3. These changes mean it is not possible
to directly compare treatment exit data from 2009-10 onwards with previous years.
Table 7.3.1 Trends in treatment exit reasons
Treatment exit
reason
Completed free of
dependency (no drug
use)
Completed free of
dependency
Total completed
free of dependency
% Completed free of
dependency
Transferred – not in
custody
% Transferred – not
in custody
Transferred – in
custody
% Transferred – in
custody
Referred on (old
code)
% Referred on
Incomplete (including
not known)
% Incomplete
(including not known)
Total
2005-06
2006-07
2007-08
2008-09
2009-10
2010-11
2011-12
2012-13
3,953
4,862
6,347
9,148
15,568
19,759
21,810
21,138
7,255
8,855
11,927
15,822
8,112
8,210
8,045
7,887
11,208
13,717
18,274
24,970
23,680
27,969
29,855
29,025
21
25
31
41
38
43
47
47
-
-
-
-
9,352
9,403
8,524
8,019
-
-
-
-
15
14
14
13
-
-
-
-
5,266
6,874
7,123
6,602
-
-
-
-
8
11
11
11
5,700
7,625
10,351
9,204
1,079
253
1
0
11
14
18
15
2
0
0
0
37,156
33,093
29,878
27,210
23,308
20,495
17,517
18,253
69
61
51
44
37
32
28
29
54,064
54,435
58,503
61,384
62,685
64,994
63,020
61,899
31
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
7.4
Trends in numbers in treatment and numbers retained for at least 12
weeks or completing treatment earlier
Table 7.4.1 shows the change in this measure between 2005-06 and 2012-13.
The proportion of over 18s who had been in treatment for at least 12 weeks or completed treatment free of
dependency has remained at 94% since 2011-12 and there has been a general upward trend from 82% in 200506.
Table 7.4.1 Trends in numbers and numbers retained for at least 12 weeks or completing treatment earlier
Year
Number in contact
with treatment
services
2005-06
175,869
Number retained for at
least 12 weeks or
completing treatment
earlier
145,051
2006-07
194,173
163,886
84
2007-08
200,805
182,775
91
2008-09
210,815
194,572
92
2009-10
206,889
192,367
93
2010-11
204,473
191,129
93
2011-12
197,110
185,428
94
2012-13
193,575
181,994
94
7.5
%
retained/completing
of all in contact
82
Trends in waiting times for first intervention
Table 7.5.1 shows trends in waiting times for a client’s first intervention, between 2006-07 and 2012-13. This
shows an increase in the proportion of clients waiting less than 3 weeks, from 87% in 2006-07 to 98% in 2012-13.
Table 7.5.1 Trends in waiting times for first intervention
Year
Under 3 weeks (n)
%
Over 3 weeks (n)
%
2006-07
62,375
87
9,143
13
2007-08
71,678
91
7,108
9
2008-09
76,168
93
5,660
7
2009-10
73,059
94
4,315
6
2010-11
69,699
96
2,906
4
2011-12
66,358
97
1,860
3
2012-13
66,888
98
1,519
2
32
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
8.
An eight year treatment population
analysis
This section presents an analysis of treatment histories for individuals across eight years of treatment data,
starting from 2005-06 (the furthest back NDTMS data is considered to be sufficiently robust for comparison with
subsequent years). Please see section 3 for information on the methodological implications of this analysis
compared with analysis elsewhere in the report where each year’s figures are calculated independently.
Table 8.1.1 reports all adults that have been in contact with treatment on or after 1st April 2005. The table is split
into three sections:

the first section reports the number of individuals that start treatment in any given year after 1 April
2005, and who are in treatment on 31 March 2013.

the second section reports all clients who were in contact with treatment in any given year after 1st
April 2005 and reports the number of these from each year who were not in treatment on 31 March
2013, and whose records indicated that treatment was incomplete at the time of discharge. (Treatment
incomplete)

the third section looks at all clients who were in contact with the treatment system on or after 1 April
2005 and who are no longer in contact with the treatment system, due to completing their treatment
and being discharged in a planned way. (Treatment complete)
Over the eight years, 390,883 unique individuals have been recorded in treatment of whom, 126,224 (32%) were
retained in treatment on 31 March 2013, of which 48,033 (38%) had only one treatment journey in this time.
142,582 (36%) had exited (treatment incomplete) while a further 122,077 (31%) had completed treatment and not
since returned.
Table 8.1.1 Eight year treatment population first presentation and treatment contact status at 31 March
2013
Year of first presentation
Category
Before
2005-6
2005-6
2006-7
2007-8
2008-9
2009-10
2010-11
2011-12
2012-13
Total
Clients retained in treatment on 31/03/2013
Continuous
journey
Two journeys
since first
presentation
Three journeys
since first
presentation
More than three
journeys since
first presentation
Retained at
16,142
3,811
2,860
2,653
2,632
2,482
2,576
3,398
11,479
48,033
10,044
4,725
3,325
2,757
2,497
2,171
1,877
1,478
695
29,569
6,656
4,206
2,593
2,015
1,529
1,078
684
277
38
19,076
11,148
9,111
4,464
2,364
1,451
682
256
67
3
29,546
43,990
21,853
13,242
9,789
8,109
6,413
5,393
5,220
12,215
126,224
33
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
Year of first presentation
Category
Before
2005-6
2005-6
2006-7
2007-8
2008-9
2009-10
2010-11
2011-12
2012-13
Total
31/03/13
No longer in contact having exited, treatment incomplete
Exited (treatment
in 05-06
6,840
9,552
0
0
0
0
0
0
0
16,392
Exited (treatment
in 06-07
2,962
5,144
8,347
0
0
0
0
0
0
16,453
Exited (treatment
in 07-08
2,606
2,231
4,492
7,759
0
0
0
0
0
17,088
Exited (treatment
in 08-09
1,987
1,539
1,653
4,072
7,014
0
0
0
0
16,265
Exited (treatment
in 09-10
2,056
1,634
1,385
1,653
3,794
5,955
0
0
0
16,477
Exited (treatment
in 10-11
2,024
1,733
1,382
1,365
1,515
3,470
5,308
0
0
16,797
Exited (treatment
in 11-12
2,468
2,067
1,488
1,288
1,259
1,221
2,879
4,875
0
17,545
Exited (treatment
in 12-13
4,215
3,495
2,407
2,054
1,835
1,582
1,530
3,149
5,298
25,565
25,158
27,395
21,154
18,191
15,417
12,228
9,717
8,024
5,298
142,582
0
0
0
0
5,889
0
0
0
0
7,969
0
0
0
0
10,644
0
0
0
0
15,137
5,572
0
0
0
15,211
5,035
6,456
0
0
19,139
1,840
5,049
6,645
0
22,316
1,437
1,791
5,403
7,025
25,772
13,884
13,296
12,048
7,025
122,077
32,525
28,406
25,292
24,538
390,883
incomplete)
incomplete)
incomplete)
incomplete)
incomplete)
incomplete)
incomplete)
incomplete)
Exited (treatment
incomplete)
No longer in contact having exited, treatment complete
Treatment
complete in 20053,108
2,781
0
0
0
06
Treatment
complete in 20061,684
2,894
3,391
0
0
07
Treatment
complete in 20071,499
1,392
3,488
4,265
0
08
Treatment
complete in 20081,595
1,392
1,562
4,991
5,597
09
Treatment
complete in 20091,479
1,173
1,050
1,440
4,497
10
Treatment
complete in 20101,855
1,482
1,236
1,366
1,709
11
Treatment
complete in 20112,566
1,880
1,496
1,362
1,478
12
Treatment
complete in 20123,138
2,347
1,611
1,548
1,472
13
Treatment
16,924 15,341 13,834 14,972 14,753
complete
Total clients in
treatment since 86,072 64,589 48,230 42,952 38,279
1st April 2005
34
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
Table 8.1.2 reports on new presentations to treatment since 1 April 2005 and gives a breakdown of their treatment
status at 31/03/2013 by drug group and by age at first presentation. Between drug groups, those presenting with
both opiates and crack cocaine were most likely to be retained with 39,185 (45%) in this category, while cocaine
powder users were most likely to have completed treatment with 20,715 (54%) having done so without
subsequently returning. Among the age groups, those aged 60 and over were most likely to no longer be in
contact with treatment and to have completed their last contact with 948 (47%) in that category.
Table 8.1.2: Treatment contact status at 31 March 2013 by drug and age group for clients commencing
treatment since 2005-06
Drug group
Exited (treatment
incomplete) prior
to 31/03/13
Retained at
31/03/13
%
%
39
45
8
7
8
9
36
7
277
56
182
37
495
100
Age group
18-24
25-39
40-59
60+
n
16,550
49,691
15,621
372
%
21
30
27
19
n
32,167
63,318
21,262
677
%
41
38
37
34
n
29,905
53,952
20,348
948
%
38
32
36
47
n
78,622
166,961
57,231
1,997
%
100
100
100
100
Total
82,234
27
117,424
39
105,153
34
304,811
100
35
36
35
49
40
41
43
n
21,707
16,745
8,308
20,715
26,032
11,464
%
26
19
43
54
51
48
Total clients
starting treatment
since 1st April
2005
n
%
84,353
100
86,637
100
19,269
100
38,631
100
51,384
100
24,042
100
n
30,151
30,707
9,454
15,343
21,040
10,452
Opiates only
Opiates / crack
Crack only
Cocaine
Cannabis
Others
Misuse
free/Not known
n
32,495
39,185
1,507
2,573
4,312
2,126
Treatment
complete prior to
31/03/13
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
Appendix 1
For the treatment year 2012-13 modality records have been analysed for completeness of selected variables.
Older modality records from episodes of treatment that have continued into 2012-13 are unlikely to have been
updated retrospectively since 2011-12. Thus, attention here has been paid only to the ‘new’ modality records for
clients triaged during 2012-13.
Please note the following analysis is based on all modality records that relate to an individual client triaged during
2012-13. However, in constructing the source data for the main reporting purposes, only a subset of the modality
records pertaining to each client or episode has been used.
Variable completeness
An NDTMS record is defined as incomplete in respect of a particular data field when no legitimate recorded value
is provided for that field. There are several NDTMS fields that may go unrecorded for legitimate reasons, such as
secondary drug, tertiary drug (the client may only be using one drug), intervention end date, discharge reason and
discharge date (the client may still be in treatment). Similarly, intervention start date and intervention type may
legitimately not be recorded if a client, although triaged, was not assigned an intervention or did not start the
treatment intervention that they were assigned.
Figure A1.1 NDTMS Data Variable Completeness: percentage of new modality level records with a missing
value
0
10
20
30
40
50
Ethnicity
Referral source
2010/11
2011/12
Previous treatment
2012/13
Injecting status
Figure A1.1 shows, for selected variables of interest, the percentage of new intervention records (those with a
triage date during 2012-13) for which a legitimate value was not recorded. The corresponding values for 2010-11
and 2011-12 are shown for comparison. Of the variables of interest, ‘injecting status’ and ‘previously treated’ were
the most incomplete variables, each having been unrecorded in over 6% and 2% of new intervention records
respectively. Ethnicity and referral source were the least incomplete, with less than 1% missing in each case.
Table A1.1 shows, for the three most incomplete variables, the percentage of new intervention level records for
which a legitimate value was not recorded in the NDTMS data for 2012-13, by region of treatment.
36
Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012-2013
Table A1.1 NDTMS Data Variable Incompleteness 2012-13: percentage of new modality level records with a
missing value, by Region of treatment
% of new intervention
records with missing value
Region of treatment
Previously
treated
London
North East
South East
Eastern
West Midlands
South West
East Midlands
Yorkshire & Humberside
North West
6
5
2
6
7
4
6
7
11
Injecting
status
2
1
0
2
3
0
5
3
3
Report authors
Malcolm Roxburgh, Information Manager, Public Health England
E-mail: [email protected]
Carol Lewis, Senior Information Analyst, Public Health England
E-mail: [email protected]
Patrick Horgan, Senior Information Analyst, Public Health England
E-mail: [email protected]
Michael Donmall, Centre Director, National Drug Evidence Centre
E-mail: [email protected]
Andrew Jones, Research Fellow, National Drug Evidence Centre
E-mail: [email protected]
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i
Drug Misuse and Dependence - UK Guidelines on Clinical Management, p85, London: Department of Health
(England), the Scottish Government, Welsh Assembly Government and Northern Ireland Executive.
ii
Jacobson N. S., Truax P. Clinical significance: a statistical approach to defining meaningful change in
psychotherapy research. Journal of Consulting and Clinical Psychology 1991; 59: 12–19.
iii
Marsden, J., Eastwood, B., Wright, C., Bradbury, C., Knight, J., Hammond, P. How best to measure change in
evaluations of treatment for substance use disorder. Addiction 2011: 106(2): 294-302
37