Take action on prevalence of opioid and/or crack cocaine use

According to Public Health England[i] about 300,000 people in England are dependent on opiates or crack cocaine.

The number of people in contact with treatment for opiates remained stable compared to last year, falling by 1% (141,189 to 139,845) with this group still making up the largest proportion in treatment (52%).

Following on from the last two years, there has been a continued rise in the number of adults starting treatment in the year with crack cocaine problems. This includes people who are using crack without opiates (4,535 compared to 4,301) and with opiates (24,363 to 22,411). While this increase is not as steep as previous years, the number of people starting treatment with crack problems has increased 32% since 2013 to 2014.

There can be many side effects of crack and/or opiate misuse including addiction, mental and physical health problems, relationship breakdowns and financial hardship.

Addiction can lead to or exacerbate depression and put those addicted in traumatic situations when under the influence of the substance or when seeking funds or drugs themselves. These cases can include overdose, assault, illness, violence, prostitution, and injury.

Short term effects of drugs and alcohol include impulsive behaviour, but long term exposure to these substances can lead to conditions such as anxiety, depression, and serious mental illnesses, all of which heighten risk of suicide.

It is also known that drugs and alcohol can be a major factor in the actual act of suicide. Many people that have completed suicide have been under the influence of either drugs or alcohol, which may have caused them to be impulsive or reduced their inhibitions.

Access to high quality substance misuse services are crucial in supporting people to recover from addiction and to manage their lives in as safe and stable way as possible.

Since 2013, when public health functions, including the commissioning of substance misuse services moved from the NHS to councils, public health budgets have been massively cut by central government and then added to by some councils who have shifted grant away from addictions services.

Action for Central Governmentcapitol building

1. Increase funding to local public health commissioners and ring-fence money for addiction services


Action for Local Authorities government building

1. Ensure you follow guidelines and invest in commissioning excellent substance misuse services

Public Health England provides excellent guidelines[ii] on commissioning substance misuse services which are vital to support better outcomes for the whole community.

Investing in effective prevention, treatment and recovery interventions is essential to tackle the harm that drugs can cause, help users overcome their dependency, reduce involvement in crime, sustain their recovery, and enable them to make a positive contribution to their family and community.

Planning is essential to addressing the harms, costs and burden on public services from drug misuse. Successful plans will be based on the assessment of local needs and community assets, and will reflect evidence of what is known to work in addressing the root causes and wider determinants of drug dependence.

Effective local systems are those that provide welcoming, easy to access, flexible services that cater for the needs of a broad range of people and their different drug problems. They raise recovery-orientated ambitions and facilitate the progress of service users toward their recovery goals, while continuing to protect them from the risks of drug misuse. They will encourage service users to complete their treatment as appropriate and when safe to do so.

Bristol ROADS[iiii]Recovery Orientated Alcohol and Drugs Service) is commissioned by Bristol City Council and is delivered by a partnership including Avon and Wiltshire Mental Health Partnership NHS Trust and voluntary sector bodies Bristol drugs Project and Developing Health and independence. Often these NHS, council and voluntary sector partnerships provide some of the best services in England.

ROADS provides: 

  • general drug and alcohol misuse advice
  • advice on detoxing, residential rehabilitation or getting an opioid substitute prescription 
  • information about how you can reduce the harm substances can cause
  • needle exchange
  • nursing support, including wound care
  • naloxone supply
  • blood-borne virus support

Drop in sessions

ROADs also have drop in sessions around the city and there are three Community Recovery Hubs around the city.