Drug and alcohol misuse are complicated, cross-cutting issues that continue to present significant challenges both locally and nationally. Drug-related harms do not only vary according to the different types of drugs being used but also the way a drug is used, the way it is used in combination with other substance and the social context in which they are used. Drugs do not only impact on those involved in misuse but on society as a whole. From families affected by drug dependency, associated criminality to the corrupting effect of drug dealing and international organised crime, drugs have a profound and negative effect on communities, families and individuals.
The latest estimates (2014/15) indicate that there are 9.0 opiate and/or crack users (OCU) per 1,000 of the population aged 15-64 living in Lancashire-12, in line with the national (8.6) and North West regional (10.6) estimates. Blackburn with Darwen (14.5) and Blackpool (20.0) both have significantly higher estimated rates of OCU than England. Lancashire-12 is similar to all but one of its statistical neighbours (Chartered Institute of Public Finance and Accountancy), with North Yorkshire being the only area to have a statistically different estimate (5.3).
In total it is estimated that there are just under 7,000 OCU (15-64) living in Lancashire-12, with males accounting for the majority (74%) of users and over two-thirds (67%) believed to be aged 35-64.
Lancashire County Council is responsible for commissioning drug misuse services across the Lancashire-12 area. Figures for 2015/16 show that 10.68% of opiate users accessing treatment services in the Lancashire-12 area successfully completed the programme and did not represent within six months, significantly above the England figure of 6.72%. Blackburn with Darwen (6.27%) and Blackpool (6.01%) both recorded rates in line with England.
Figures relating to the treatment of non-opiate drug users (2015/16) show that 50.09% of users accessing services across the Lancashire-12 area successfully completed treatment without representing within six months, significantly above the national picture (37.26%). Blackburn with Darwen (36.59%) recorded a rate in line with England, whilst Blackpool (50.64%) recorded a rate significantly above it.
Analysis of locally held hospital admissions data over the 2012/13-2015/16 period found that there were a total of 885 hospital admissions recorded across the six Lancashire-12 clinical commissioning groups (CCGs) with a primary diagnosis of drug-related mental health and behavioural disorder (ICD10: F11-F16, F18 and F19). The majority (746) of these admissions were emergency admissions. Combined, the six CCGs in Lancashire-12 have a crude emergency admission rate of 20.90 per 100,000, with the East Lancashire CCG recording a significantly higher rate of 27.70. Fylde & Wyre CCG (19.44) recorded a rate in line with the combined figure, whilst the remaining CCGs all recorded rates significantly lower than it; Chorley & South Ribble (16.13), Greater Preston (18.41), Lancashire North (18.18) and West Lancashire (16.33).
Further analysis found that 80% (598) of emergency admissions came from persons aged 42 and under, 77% were male and almost half (45%) involved those living in areas classified as being with the most deprived quintile (IMD2015 – Quintile 1).
Nationally published figures relating to deaths related to drug poisoning for 2014-2016 (Includes accidental poisonings and suicides) show that there were 190 deaths across the Lancashire-12 area during this three year period. This gave the area an all-persons, age-standardised mortality rate per 100,000 of 5.8, significantly above the England rate of 4.2. At a district level, the areas of Burnley (11.3), Hyndburn (9.3) and Pendle (7.8) also recorded figures that were significantly above the national rate. At the other end of the scale, South Ribble (1.0) district recorded a rate which is significantly below the England rate and a number of other districts within Lancashire-12. Additional analysis, finds that two fifths of drug related deaths, in Lancashire-12, occurred across just five districts; Burnley (27 | 14%), Hyndburn (21 | 11%), Lancaster (22 | 12%), Pendle (20 | 11%) and Preston (22 | 12%).
The neighbouring authorities of Blackburn with Darwen (7.7) and Blackpool (20.1) also recorded rates that were significantly above England. The Blackpool rate was found to be significantly above all but one of the Lancashire-12 districts, with Burnley being the exception.
Gender level analysis find that males have a significantly higher drug related deaths rate than females, at both a national and Lancashire-12 level. Blackpool and Burnley both have male and female rates that are significantly above the national averages, whilst South Ribble has male and female rates which are significantly below it. Hyndburn was also found to have a significantly high male rate of drug related mortality.
Analysis of locally held mortality data, focusing on those deaths recorded against the ICD-10 block "Accidental poisoning by and exposure to noxious substances", found that there were 201 such deaths between 2014 and 2016. Of these, 127 (63%) were coded with the underlying cause of death code X42: Accidental poisoning by and exposure to narcotics and psychodysleptics [hallucinogens], not elsewhere classified, which refers to deaths involving substances such as cannabis, cocaine, codeine, lysergide (LSD) and heroin. Further analysis, found that on average there were 42 such deaths, per year over the three-year period, with 50 deaths recorded in 2015. The majority (87 | 69%) of these deaths were male, 77% (98) were aged 30-54, 65% (82) occurred in a home setting and over half (72 | 57%) of deaths involved individuals living within with neighbourhoods (LSOAs), classified as being amongst most deprived areas in England (IMD2015 – quintile 1)
Many young people receiving specialist interventions for substance misuse have a range of vulnerabilities. These include those not in education, employment or training (NEET), those in contact with the youth justice system, and those who experience domestic abuse and sexual exploitation. Alcohol and drug use amongst young persons is also associated with early sexual initiation and other risky sexual behaviours.
In 2014-15, there were 446 young people aged under-18, and 126 aged 18-24 in specialist substance misuse (including alcohol) community services across the Lancashire-12 area. A further 21 young people aged under 18 were in specialist services within the secure estate.
For the three-year period 2013/14-2015/16, the Lancashire-12 area recorded 633 hospital admissions due to substance misuse among persons aged 15-24. Giving the area a directly standardised per 100,000 of 137.6, significantly above the national average of 95.4. Blackburn with Darwen (225.8) and Blackpool (345.3) also recorded rates that were significantly above the national average.
The comprehensive lifestyle questionnaire (XLSX 248 KB) of the 2015 health behaviours JSNA provides further insight into drug use (and other lifestyle behaviours) in Lancashire-12. The substance misuse secondary data analysis (PDF 686 KB) focuses on the data, and combined with the questionnaire and the final health behaviours report (PDF 1.9 MB) identifies priorities and recommendations around drug use for Lancashire-12, with individual district and clinical commissioning group profiles also available.
Further analysis and data
Health behaviours lifestyle questionnaire (XLSX 248 KB)
Page updated October 2017