Cocaine drug of choice for under-25s, NHS figures suggest
• Fewer young addicts using heroin and crack
• Trend poses challenge to treatment services
Fewer young adults with a drug problem are using heroin and crack – the two substances most likely to cause addiction, increase crime and pose serious health risks – but the number of under-25s seeking treatment for dependency on cocaine is rising significantly, official figures show.
The trends are revealed in a previously unpublished analysis by the NHS's National Treatment Agency for Substance Misuse (NTA) of data on addicts in England who receive treatment for their drug habit. The agency believes that the statistics "herald a generational shift in patterns of drug dependence in England".
NTA data passed to the Guardian shows that the number of 18- to 24-year-olds newly presenting for treatment for heroin or crack fell by 22% from 12,320 in 2005-06 to 9,632 in 2007-08, even though drug treatment was more readily available than ever. However, the number of over-35s seeking treatment for the first time rose by 11%, from 20,465 in 2005-06 to 22,770 two years later.
Over the same period, the number of young adults seeking help from a drug treatment service for cocaine problems rose from 1,591 to 2,692 – a rise of 69%.
Overall, the number of young adults seeking help for misuse of heroin, crack or powder cocaine fell from about 14,000 in 2005 to about 12,000 in 2008 – evidence of another encouraging trend.
The NTA's annual report, to be published on Thursday, is expected to confirm that both the shift away from heroin and crack and the growing problem of cocaine addiction in under-25s continued in 2008-09.
Paul Hayes, the NTA's chief executive, said: "It is reassuring that younger people seem to be turning away from heroin and crack. The quite significant reduction in the numbers of people seeking help [for those drugs] probably illustrates an actual fall in problematic use because help has never been more available.
"Fewer people using heroin is good news as heroin is the most dangerous of all the drugs that people use. Given it involves a significant risk of overdose, HIV and hepatitis C, and is associated with acquisitive crime, I'm convinced that individuals, communities and wider society will benefit, especially the poorest communities, which heroin affects most."
However, the increase in cocaine dependency among the same age group was "very significant" and worrying, added Hayes. "There's been an increase in cocaine use generally for a few years, especially in the younger age groups, and that's now being reflected in significant additional numbers being treated for cocaine. That's worrying because cocaine dependency can be associated with health damage, crime and problems in individuals, although it's not as problematic as heroin because it's not injected."
Heroin became a major problem in Britain in the 1980s amid growing unemployment. Better economic circumstances in recent years may help to explain its declining popularity among younger drug users, said Hayes. In addition, he said, "people understand now what using hard drugs like heroin and crack leads to, whereas in the 1980s people weren't so aware of its consequences. It's lost a lot of its glamour. It's associated with losers rather than risk-takers. Heroin and crack are seen as dirty, nasty, horrible drugs, whereas cocaine can be seen by some people as an adjunct to the party lifestyle, in the same way that alcohol can be."
The NTA's research tallies with growing evidence from frontline drug workers that younger users are increasingly using cocaine as part of a combination of illicit substances. "The emerging problems facing drug projects who run young people's services aren't [clients using] heroin and crack but strong alcohol, strong cannabis, cocaine and ecstasy – a different basket of drugs to the older generation," said Harry Shapiro, of Drugscope, which represents about 800 local drug agencies in the UK. Experts refer to this pattern of drug use as "the ACCE profile".
In all, 530 young adults aged 18-25 were referred to the Mosaic drug and alcohol service in Stockport in 2007-08. Of those, 193 were seeking treatment for cannabis, 175 for alcohol, 115 for cocaine and only 27 for heroin. A survey of men aged 19-25 in the town found that the drugs that most had tried were cannabis (64%), powder cocaine (33%) and ecstasy (32%). Cocaine's greater availability and ensuing cheaper price is believed to explain its popularity.
"It's good that fewer young people appear to be using heroin," said Shapiro. "But the fact that young people who have drug problems now increasingly have problems of cocaine, cannabis and alcohol addiction means that we still have a serious problem here. There's also a challenge in this for drug treatment services, which are very much geared up to the needs of heroin users, and their ability to deal with a new generation of problem drug users who don't fit the traditional profile."
Roger Howard, chief executive of the UK Drug Policy Commission thinktank, said: "There is a generational shift under way, with older, more chronic heroin users entrenched in heroin and a younger adult group who are much more into multi-drug use. It's worrying that we're seeing more people with multiple drug use because they are much more difficult to treat."
The fact that cocaine users are usually better-off and less isolated from their families than heroin users may make them less likely to ask the UK's network of drug services for help, he added.
Denis Campbell, health correspondent
guardian.co.uk, Sunday 4 October 2009 18.36 BST