About a third of the population admit to taking drugs at some stage in their lives, and about a quarter of young adults say they have used drugs in the last year, but few people go on to develop serious problems. In fact, less than 1% of the population used opiates (heroin) or crack in the past year. Most will use a handful of times and stop when they realise where it is heading, before they become addicted. There are around 306,000 adult opiate and/or crack cocaine users in England. More than half receive treatment in the community and in prisons.  For those who do develop problems, treatment is widely available in England.

Drug dependency is a complex health disorder with social causes and consequences. No single factor can predict whether or not a person will become addicted to drugs.  Risk for addiction is influenced by a person's personality, social environment, biology and age or stage of development.  The more risk factors an individual has, the greater the chance that taking drugs can lead to addiction. The International Statistical Classification of Diseases and Related Health Problems (ICD-10) defines dependency as:  'A cluster of behavioural, cognitive, and physiological phenomena that develop after repeated substance use and that typically include a strong desire to take the drug, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to drug use than to other activities and obligations, increased tolerance, and sometimes a physical withdrawal state.' This definition underpins current UK and most drug treatment policy approaches in the Western world.

There is significant public concern about young people's misuse of drugs and alcohol. Though this concern is understandable, there is little evidence to support the perception that drug and alcohol use is spreading among young people. Drug use statistics show downward trend in drug use among school pupils and young people.  However, evidence suggests that a small minority who are misusing drugs are doing so more problematically.

Addiction is rare among young people under 18.  Very few pre-teens need help for harmful drug or alcohol use.  The widespread availability of services ensures that many more young people who need help are getting it.  The vast majority of under-18s in contact with drug treatment services – almost nine out of ten – are receiving help for problems associated with the misuse of cannabis and/or alcohol.  NTA analysis of trends in services offered to under-18s over the last four years shows a steady decline in the reported problems with the drugs more commonly associated with addiction in adults, such as heroin or crack.

The NTA is a special health authority which aims to improve the availability, capacity and effectiveness of drug treatment in England.

Since drugs policy cuts across the work of several government departments, the NTA has a central role in co-ordinating the delivery of treatment services The NTA reports to the Department of Health, and works closely with the Home Office, the Department of Education, the Ministry of Justice and the Department of Work and Pensions.

The NTA's key role is supporting local drugs partnerships to ensure that they accurately assess the local need for drug treatment and commission an appropriate balance of good quality provision, in line with national clinical guidelines and the government's drugs policy.

The NTA also hosts and runs the National Drug Treatment Monitoring System (NDTMS) and the National Alcohol Treatment Monitoring System (NATMS) on behalf of the Department of Health. These provide detailed data on drug and alcohol treatment in England, which once published, helps local partnerships make decisions about how well their treatment services are meeting local need.

The Government has recently signalled a radical shift in its approach to drug and alcohol misuse. Instead of focussing primarily on reducing the harms caused by drug misuse, it will create an integrated drug and alcohol recovery system with the needs of individual users at its heart. This new ambition for recovery will be delivered by locally-owned and led recovery systems to be supported at a national level by Public Health England, which will assume the key functions of the NTA from 2013.

During the interim period the NTA will drive the transformation from a 'treatment system' to a 'recovery system' in line with the drug strategy. Until the NTA ceases to exist as a separate organisation, it has three main priorities:

1. Preparing for the transition to Public Health England
2. Implementing the Government's recovery vision
3. Consolidating the improvements in the drug treatment system achieved since 2001.

The NTA has helped drug misusers, their families and communities by driving improvements in the drug treatment system in England since 2001. More than doubling the numbers of people in drug treatment, and keeping them in for longer in order that they benefit, has meant improved health and reduced crime for both individuals and their communities. Recent Home Office research has shown that spending £1 on drug treatment saves £2.50 in crime and health costs of drug addiction. This finding has now been endorsed by the National Audit Office.

Most drug treatment focuses on people who become dependent on illicit drugs. It encompasses a range of treatments and services which scientific evidence shows help people overcome their dependency and reduce the harms caused by drugs to themselves, their families and communities.   England has a balanced treatment system which ranges from the provision of sterile needles and advice to those who have yet to enter drug treatment (in order to reduce the spread of blood-borne viruses in the community) through to complex treatment interventions like inpatient detoxification and residential rehabilitation.

Each individual's drug treatment should be based on their individual needs. No single treatment programme is appropriate for all individuals, and effective treatment will attend to the multiple needs of the individual, and not just tackle their drug use. There are three main components which contribute towards a balanced treatment system: pharmacological (medical), psychosocial (talking therapies), and social/peer support approaches such as Narcotics Anonymous (NA), which, used together, can enable people to recover and move on from their dependency on illicit drugs and make a positive contribution to their family, community and society. Recovery from drug dependency can be a long-term process and frequently requires multiple episodes of treatment.

Drug treatment is aimed at those who are assessed as having dependency problems with illicit drug misuse. Getting offenders, and parents whose drug use may put their children at risk, into effective treatment quickly is particularly important, but anyone in England who needs treatment can get it, and quickly. The majority of services are free at the point of contact for residents in England from the NHS and various voluntary sector providers

Harmful drugs are illegal, but unfortunately that does not stop some people using them.  However, relatively few casual drug users go on to develop serious problems, and not every illegal drug user requires specialist treatment. There isn't really such a thing as a 'typical drug user', though people dependent on opiates like heroin and/or crack cocaine are statistically more likely to be white, male, in their thirties, from a background of high social deprivation and with multiple, entrenched and complex needs.

No. Drug treatment is available for all those assessed as needing it. Many people addicted to hard drugs do commit acquisitive crimes to obtain illicit drugs, but the majority of those who come into treatment do so through their own choice or are referred by their GP or another part of the NHS.  Around a quarter are referred into treatment through the criminal justice system.  Evidence shows that treatment does not need to be voluntary to be effective. The NTA's work with the drug treatment sector has brought down average waiting times to less than a week, which means that people who need drug treatment can access it quickly, and do not need to go down the criminal justice route.

Drug dependency is a health disorder that affects not only drug users but also their families and the communities they live in. Left untreated, drug addiction causes serious health and crime harms for individuals, their families and the wider public.  Drug misusers are at risk of death from an overdose, they may contract and spread blood-borne viruses, suffer poor physical and mental health, and commit offences; all of which impacts upon families, communities and wider society. Dealing with these harms costs the tax payer an estimated £15.4bn a year.

The National Audit Office's two-year investigation into tackling problem drug use concluded in March 2010 that treatment delivers value for money for the taxpayer.  Home Office research found that for every pound spent on treatment, society gained £2.50 worth of benefits, mostly by cutting crime.

Effective recovery orientated drug treatment addresses the multiple needs of individuals, not just their drug use. Over time, most people are able either to overcome dependency, or manage it and lead more meaningful lives including holding down a job, attending education and training, and caring for their children and families.

Effective drug treatment can also bring many benefits to a community. While addicts are in treatment they use fewer illegal drugs and commit less crime to fund the purchase of drugs. Treatment offers an individual the prospect of long-term recovery; and it provides society with safer neighbourhoods through an immediate respite from the harm caused by drug misuse.

Recovery from drug dependency can be a long-term process which typically follows a pattern of lapse, relapse and repeated attempts at treatment before sustained recovery can be achieved.   Drug treatment keeps people alive by preventing overdose and the spread of blood-borne viruses such as HIV and hepatitis.  It is also associated with improved physical and mental health and reduced criminal behaviour.  Effective drug treatment, combined with access to other health and care services to enable drug users to acquire the social and personal capacity they might lack, will aid their longer-term recovery. There is robust evidence that drug treatment either helps people to overcome their dependency, or enables them to manage it and lead normal lives.  For most drug users, treatment is effective.

Some drug users have the personal capacity to eventually recover from their drug use naturally, without treatment. These people tend to achieve this through a number of routes including utilising their own personal and social skills, family support, mutual aid and peer support and growing out of the drug-using lifestyle.

No single treatment is appropriate for all individuals. The NTA supports a balanced treatment system in England with a range of community, inpatient and residential rehabilitation services as the most effective way to deal with the various individual treatment needs of problem drug use.

Residential rehabilitation is suitable for some individuals at particular moments during their lives but it is not necessarily the best or most cost-effective treatment option for everyone.  The National Institute for Health and Clinical Excellence (NICE) has concluded that community treatment is effective for all but the most complex cases. Although some people will become drug-free in rehab, there is no guarantee that this will be sustained when they return to their communities – so there needs to be an effective programme of community-based support to help people stay clean after getting off drugs through treatment. 

The NTA has consistently urged local commissioners to ensure that residential options are available for those who would benefit from them, and has managed an investment programme to enure there is an adequate supply of accommodation.  The NTA is now working on criteria to match individual clinical need as closely as possible to the location, intensity and duration of treatment that is most likely to be effective.

Most of us know someone who has tried to give up smoking, stopped for a while and then started again before eventually stopping for good; this is the nature of dependency.  Similarly, drug dependency is a chronic condition normally characterised by relapse and remission, which can even follow successful episodes of treatment. The majority of problem drug users have multiple complex needs which cannot all be dealt with through the medical process of diagnosis, treatment and cure. Even though most people get better, sustained recovery may take a number of years, and it may not be achieved following someone's first go at treatment. Typically, sustained recovery is achieved after a few unsuccessful attempts at treatment, and when all the multiple needs of that person are met through additional support which focuses on long-term recovery and change.

Cannabis is the most popular drug among occasional or casual users but no causal link between current cannabis use and the future use of more problematic drugs such as heroin or crack has ever been proved.

If you suspect that your child is experimenting with or misusing drugs, the best way to find out is to talk to them in a non-judgemental way, encourage them to be open and honest about what is happening in their lives and to share their concerns with you. If you do not know how to talk about drugs with your child seek advice and support materials from your GP or community health centre, education department or social services. You may also find it helpful to contact an organization that supports families affected by drug misuse, such as Adfam. Alternatively, you can call the national drugs helpline FRANK (0800 77 66 00) or go directly to your nearest young people's substance misuse service.

Most over-18s access treatment support by finding their nearest drug treatment service through their GP, social worker, other health professional, or through the national drugs helpline FRANK (0800 77 66 00) or through DrugScope's helpfinder service on www.drugscope.org.uk.  Mutual aid and support groups (such as Alcoholics Anonymous and Narcotics Anonymous) are also available. This information and support is available in communities throughout England. If you are concerned for a child or young person under-18, support and specialist young people's treatment services are available through the same routes but services are specifically tailored to the needs of young people.

No.  The NTA's role is to ensure access to effective treatment for drug misusers in England to help them recover and it is the Agency's view is that legalisation would probably lead to increased drug use, particularly among more vulnerable individuals, resulting in increased health harm to those individuals, greater threat to the public and an increase in drug-related deaths.

No. The aim of all drug treatment is to reduce the harm drugs cause to users, help them overcome their addiction, sustain their recovery, and make a positive contribution to their family and community.  Substitute medication, such as methadone or buprenorphine, is recommended by the National Institute for Health and Clinical Excellence (NICE) and should be combined with psychosocial support as the first line treatment for heroin addiction, which is in line with the approach taken in the majority of Western Europe. Methadone is one of the most studied pharmaceuticals in modern medicine. Extensive research shows that supervised methadone consumption has reduced the number of deaths due to methadone overdose during the time of growth in heroin addiction and the expansion of methadone prescribing treatment. There is strong evidence that, combined with psychosocial support, methadone treatment can lead to improved outcomes, such as decreased death rates, reduced transmission of blood-borne viruses, eliminated or reduced opiate (heroin) use, reduced criminal activity, improvements in employment, education and training, and improved overall health and social functioning. 

No-one should be maintained indefinitely on methadone or similar opiate substitutes without the opportunity to get off drugs.  The NTA is working with experts in the field to develop new clinical protocols to focus practitioners and drug users on abstinence as the desired outcome of treatment. The review group will consider how to prevent unplanned drift into long-term maintenance.  Sound evidence-based clinical judgement endorsed by clinical governance should be able to identify cases where the approach would not be appropriate, but the intent is to see a fundamental shift in the balance of treatment for opiate addiction away from long term maintenance and towards abstinence and long-term recovery.

Although England has comparatively high numbers of people experiencing drug problems in the Western world, it also has one of the highest proportions of these people in treatment, suggesting this country is making a considerable impact on drug addiction. With waiting times better than ever before, most adults who need it, access drug treatment in England in a week or less.  

Despite the relatively high number of injecting drug users, England has one of the lowest rates of HIV and hepatitis C among this group. This significant public health success followed early establishment of a comprehensive network of services – such as needle and syringe programmes – to reduce the harm that injecting drug use brings, and the wide availability of opioid substitution and other drug treatments in services across England. 

Recorded rates of drug-related deaths are higher in England than in most other European countries.  This is likely a reflection the fact that the population of injecting drug users in England since the 'epidemic' of the 1980s is growing older.  It is likely that individuals with a long history of drug dependency are in poorer health, engage in more dangerous injecting behaviour and are at greater risk of dying from overdose.  Wide availability of opioid substitution treatment – such as methadone and buprenorphine – for the most problematic drug misusers is the best defence against drug-related death and the reason why drug-related death rates in England are not even higher.

England is leading the way internationally on drug treatment outcomes work and is probably the only country in the world where there is a national system for recording the outcomes of people currently undergoing treatment.

There are around 306,000 heroin and crack users in England. More than half of these receive drug treatment in the community or in prison.  Locally, the NTA provides data setting out how many estimated heroin and crack users there are and how many are in treatment. This helps inform the annual local needs assessment which identifies people who need help locally and who are not already benefiting from treatment. The treatment planning that follows sets out, among other things, local ambitions to ensure more people with drug problems get the help they need. 

In addition, the NTA is working with government departments to reach drug users who are not currently in treatment. Work with the Department for Work and Pensions (DWP) and local Jobcentre Plus is evolving and aims to get more drug addicts who are on benefits into treatment, to enable them to recover and move on from their dependency and make a positive contribution to their family, community and society in ongoing. 

The NTA continues to work with the Home Office on the Drug Interventions Programme that operates across the full range of criminal justice settings (i.e. police stations, courts, probation services and prisons) to identify drug misusing offenders who are not in treatment and referring them into specialist services to get the help they need,

Anyone misusing illicit drugs and who wants to stop is encouraged to seek treatment as soon as possible. They can get details from their GP, social worker, other health professional, or through the national drugs helpline FRANK (0800 77 66 00) or through DrugScope's helpfinder service on www.drugscope.org.uk 

While specialist treatment services focus on treating illicit drug misusers, they will also treat additional use of other drugs as part of their client's overall dependency. This includes addiction to drugs prescribed for anxiety and depression. Those experiencing primary dependency problems with these prescription or 'over-the-counter' (OTC) drugs will also have access to GP and other specialist services that are commissioned locally.

The NTA recently produced a report on behalf of the Department of Health which sought to determine the scale and implications of the use of addictive medicine In England. This follows the recommendations from the all parliamentary group inquiry into addiction to prescription and over-the-counter medicine published in June 2009. The government's Drug Strategy 2010 makes clear that the new locally owned and led recovery focussed treatment systems it envisages will be expected to take a broad approach to treating substance misuse, including prescription and over the counter medicines.

Anyone concerned about their use of alcohol or prescription/ OTC drugs should go to their GP or seek advice from their social worker, other health professional, or through the national drugs helpline FRANK (0800 77 66 00).

Many people who are dependent on illicit drugs also misuse alcohol. The treatment they receive through specialist treatment services will primarily address their problematic illicit drug use, but will also treat their misuse of alcohol. The Department of Health is currently responsible for policy on alcohol dependency, and those experiencing problems mainly with alcohol will be treated via local specialist services.

The government's Drug Strategy 2010 makes clear that the new locally owned and led recovery focussed treatment systems it envisages will be expected to take a broad approach to treating substance misuse, including alcohol and prescription and over the counter medicines. This alignment of drug and alcohol treatment will it is hoped drive future improvements to services for severe alcohol dependence.

The Government will set out further details about its approach to treating alcohol dependence in a new alcohol strategy expected soon. Meanwhile, anyone concerned about their use of alcohol should go to their GP or seek advice from their social worker, other health professional, or through the national drugs helpline FRANK (0800 77 66 00).