The media and those who have their own drug policy agendas will frequently assert that drug use in this country has ‘spiralled out of control’. However, according to the data measures we have at our disposal, overall use across all age ranges in the UK has actually been falling. This applies to drugs such as cannabis as much as it does to heroin and crack cocaine – among the 16 to 24 age group, cannabis use has nearly halved since its peak in 1998. We have seen a decline in the numbers of both adults and young people presenting to treatment services and an increase in the numbers of planned exits from treatment. And in line with other countries in western Europe, our heroin and crack using population is ageing. While the obvious question is ‘what’s going on?’, the answer is less straightforward.
In very general terms, at least until 2008, the UK enjoyed a sustained and strong economy; this could help explain some of the decline in drug use. Contrast the relatively affluent nineties and noughties with the 1980s, and the growth of heroin use against a backdrop of mass unemployment and rising poverty and social exclusion. Again, more generally and in epidemiological terms, drug use can go in cycles. For example, crack use peaked in the USA in the 1980s, and then experienced a downturn without any obvious explanation.
Looking at more ‘recreational’ use across the wider population, drug use might be as much a ‘victim’ of fashion as any other cultural phenomenon and, at the moment, drug use isn’t quite as cool as it was. It may be that the inexorable rise of social media, and subsequent changes in the way young people socialise and occupy their time, is having an influence on behaviour and attitudes towards drug use.
Where cannabis is concerned, the home grown market in ‘skunk’ now dominates over imported cannabis resin. With forensic evidence demonstrating that most skunk is on average about three times stronger than resin, it might well be too strong, unpredictable and unpleasant for many people. Conversely, the decline in the use of heroin could be linked to a decline in the levels of purity, for reasons which remain unclear. Many young people, perhaps scared by the experience of members of their community, friends or family members, see it as a ‘dirty’ drug.
So overall, the news is encouraging, but there has to be a note of caution. Firstly, we still have around 300,00 people with serious heroin and crack problems – and the drug and alcohol sector will need to adapt to the new public health environment from April 2013, with multiple competing pressures on funding.
Furthermore, there is evidence to suggest that the UK drug scene may be in a period of transition, rather than terminal decline. The history of drug use in the UK is not a straightforward upward line; there have been ‘tipping points’ prior to each developmental stage, as seen in the late 1980s, for instance, with the arrival of ecstasy and rave culture. Now, we have the internet. There has been talk for some time, in the media and elsewhere, of the impact of the internet on the drug scene; it is clear now that the opportunities presented by the world wide web has driven the manufacture, supply, purchase and information exchange of a bewildering array of so-called ‘legal highs’, while internet pharmacies have put a range of powerful painkillers and sedative drugs within reach of a computer and a credit card. This online activity has seen, for example, the rise of mephedrone and synthetic cannabis in the UK and the increasing use of painkillers and other prescription drugs such as Tramadol among vulnerable groups, a situation highlighted by the Chief Inspector of Prisons in his most recent report.
We are about to enter the biggest change to the treatment and recovery landscape for a decade, at a time of financial uncertainty, while trying to protect the health gains of recent years and gearing up for what might be a very different drug environment in the years to come. For all professionals involved in the care of those experiencing drug problems, the challenges ahead are far from insignificant.
 According to the British Crime Survey Drug Misuse Declared, 15.7 per cent reported last year use of cannabis in 2011/12; this figure was 28.2 per cent back in 1998.