NHS England holds several data sources covering alcohol use for people aged under 18 years old, including the Smoking, Drinking and Drug Use among Young People survey. This data is collected every two years, and the next survey report is due Autumn 2024, and will include 2023 survey data.

The guidance from England’s Chief Medical Officer for healthcare professionals is clear, an alcohol-free childhood is the healthiest and best option. The Department promotes this through online platforms such as the NHS.UK website, and the Talk to FRANK online resource. Local authorities promote these guidelines as part of their public health duties.

Alcohol or drug dependence is rare in children and young people under the age of 18 years old, although they may be drinking problematically. For those that do need support, the Department has allocated £532 million of additional funding through to 2024/25 to support improvements in treatment, including facilitating 5,000 more young people into age-appropriate alcohol and drug treatment.

Alcohol or drug dependence is rare in young people under the age of 18 years old, although they may be drinking problematically. The most effective and sustainable approach to reducing alcohol and drug harms in young people is by giving them the best start in life, the best education possible, and keeping them safe, well, and happy.

Statutory guidance on relationships, sex, and health education requires all primary and secondary school pupils to be taught the key facts and risks of alcohol and drug use, as well as how to manage influences and pressure, and keep themselves healthy and safe. The Department has worked with the PSHE Association to develop the lesson plans on alcohol and is currently commissioning an update of the resources, to be published later this year. Current resources are available at the following link:

https://pshe-association.org.uk/drugeducation

Through the cross-Government Drug Strategy, the Department has allocated £532 million of additional funding through to 2024/25, to support improvements in alcohol and drug treatment, including facilitating 5,000 more young people into age-appropriate treatment by 2024/25. Local authorities can also invest their allocation in options from a menu of interventions, some of which include strengthening the services available to young people and families.

The Government also has an information and advice service called Talk to FRANK, which aims to reduce alcohol and drug use and its harms by providing awareness to young people, parents and concerned others:

https://www.talktofrank.com/

Tobacco is uniquely harmful, with no safe level of smoking, and no other consumer product that kills two thirds of its long-term users. It causes one in four cancer deaths, including 70% of lung cancer cases, and takes approximately 80,000 lives every year. The latest estimates from Action on Smoking and Health put the cost of smoking in England at over £21 billion. This includes an annual £18 billion loss to productivity through smoking related lost earnings, unemployment, and early death, as well as costs to the National Health Service and social care of £3 billion.

The Department estimated the annual cost of alcohol consumption to the NHS to be £4 billion in 2021. The previous estimate published alongside the Government’s 2012 Alcohol Strategy was updated to reflect inflation. The Department has begun a review of existing methods and evidence to update this estimate. The estimated costs of alcohol and smoking related illnesses to the NHS were not designed to be compared, and are based on different methods, data sources, and time periods.

The Government takes a wide-ranging approach to reducing alcohol related harms. Several aspects of the Department's work to address alcohol related harms already follows a harm reduction approach. These include the UK Chief Medical Officers’ low-risk drinking guidelines, which recommend that people moderate their drinking to 14 units a week, and guidance from England’s Chief Medical Officer for healthcare professionals, on the consumption of alcohol by young people. The National Health Service’s Better Heath campaign aims to motivate people to take steps to improve their health, including in relation to alcohol use, and the NHS Health Check provides an opportunity for general practitioners to offer advice to reduce alcohol use, if appropriate.

In relation to treatment, the Department is committed to promoting access to alcohol services through our drug strategy. The upcoming UK clinical guidelines for alcohol treatment will include a chapter on taking a harm reduction approach within alcohol treatment, which outlines a flexible service approach. The Department, in partnership with the devolved administrations, will publish these guidelines later this year.

The following table shows the number of finished admission episodes with a primary diagnosis recorded for cannabis use, in each of the last five years:

Source: NHS England publishes information on hospital admissions, which is available at the following link: https://digital.nhs.uk/data-and-information/publications/statistical/hospital-admitted-patient-care-activity

We have a range of metrics which we monitor to assess the success of our work to reduce alcohol harm, including the Health Survey for England. The Government takes a wide-ranging approach to addressing alcohol-related harms, including promoting the United Kingdom’s Chief Medical Officer’s low risk drinking guidance. Approximately 80% of adults drink within the guidelines of 14 units of alcohol a week.

Population level alcohol consumption has remained stable over recent years. Among children aged 11 to 15 years old, alcohol consumption has decreased significantly in the last 20 years. However, while we are seeing an increasing number of people drinking at lower levels or abstaining, we have also seen more people drinking at higher-risk levels. As a result, some indicators of harm have increased, and we are committed to addressing these, including through the establishment of alcohol care teams in the 25% acute hospitals in England with the greatest need, through the NHS Long Term Plan.

Community treatment for alcohol dependence is highly effective. In 2020/21, 62% of people in alcohol-only treatment completed treatment free of dependence, the highest completion rate for any substance misuse group. We have committed to making further improvements to the alcohol and drug treatment system through the 10-year Drug Strategy.

The Department for Education’s statutory guidance, Relationships education, relationships and sex education and health education, became mandatory in September 2020. Through this, education on drugs, alcohol, and tobacco became compulsory at state-funded primary and secondary schools, teaching children and young people how to manage influences and pressure, and keep themselves healthy and safe.

The Government also has an information and advice service called Talk to FRANK, which aims to reduce the use of substances and their harms, by providing awareness to young people, parents, and concerned others. Further information is available at the following link:

https://www.talktofrank.com

Guidance from England’s Chief Medical Officer for healthcare professionals is clear, that an alcohol-free childhood is the healthiest and best option. The Department promotes these through online platforms such as NHS.UK website, the Talk to FRANK online resource, and the GOV.UK website. Local authorities promote these guidelines as part of their public health duties.

The Department maintains an interest in the effectiveness of policies implemented by other countries, to reduce alcohol harms. The 2016 Public Health England publication, The public health burden of alcohol: evidence review, reviewed effective policies for reducing alcohol harms in countries who are members of the Organisation for Economic Co-operation and Development. Officials in the Department frequently engage with international colleagues, and those in the devolved administrations, to exchange ideas, experience, and evidence when developing new policies.

The Government was involved in the work by the World Health Organization (WHO) to develop an action plan to strengthen the implementation of the Global Strategy to Reduce the Harmful Use of Alcohol. We were pleased that the action plan was adopted at the 75th World Health Assembly in May 2022. The United Kingdom will continue to work with the WHO and member states on alcohol harm reduction.

The following table shows the number of hospital admissions in England due to intentional self-poisoning by, and exposure to, alcohol, each year from 2017/18 to 2021/22:

Source: Alcohol Profile - Hospital admissions due to alcohol, from the Office for Health Improvement and Disparities, available at the following link:https://fingertips.phe.org.uk/profile/local-alcohol-profiles/supporting-information/admissions2

The Department is planning to write, jointly with the National Police Chiefs’ Council, to local authorities, Directors of Public Health, and police forces and their partners, to provide planning advice for festivals over the summer. The guidance included in this letter will help minimise the risk of harm to individuals around such events, and will include specific reference to synthetic drugs.

The Government recognises the potential harm reduction benefits of back-of-house drug checking facilities (DCFs) within this type of event. Back-of-house DCFs are those which test surrendered or confiscated drugs, but do not return the drugs to the individual or give individualised information on the content of the drugs, to avoid sending a message that taking any illegal drug can be safe. Instead, they enable localised public alerts if toxic or extremely dangerous drugs are detected. Organisations wishing to deliver back-of-house DCFs will need to apply for a Home Office licence and operate responsibly, in line with Government policy, to ensure that they discourage drug use and signpost potential users to treatment and support.

The Department has a longstanding surveillance system in place to collect information on the nature and location of novel drug use and drug markets, and receives reports alerting us to harms experienced. Work is ongoing to improve drug surveillance on synthetic opioids, through development of an early warning system which will include new data feeds, such as ambulance call-out data.

For surveillance purposes, the Office for Health Improvement and Disparities reconciles local and regional reports received via our drug alerts system, with police force reports received by the National Crime Agency, to arrive at an agreed figure for recent nitazene deaths. Statistics on the number of deaths related to other synthetic drugs are reported by the Office for National Statistics, and will be published in its annual report on the number of deaths related to drug poisoning.

We are committed to ensuring that anyone with a drug dependency can access the help and support they need. For those using opiates, treatment is the safest place to be. The Government is investing an additional £780 million over the three years to 2024/25, the largest ever single increase in treatment and recovery funding in England, to create a world-class treatment and recovery system. We are investing £532 million to improve drug and alcohol treatment, and recovery services specifically. This funding is in addition to the Public Health Grant, and will grow the capacity and quality of the drug treatment system.

We are working with an expert clinical group to review the treatment for opioid dependence, including synthetic opioids. However, the current view is that whether or not drugs are synthetic is unlikely to affect the treatment and care that is appropriate.

The Department is actively monitoring, and responding to, the continued threat posed by the growing levels of potent synthetic opioids in the United Kingdom. We are working to increase awareness of the dangers of synthetic opioids. The Government’s drug information and advice service, Talk to FRANK, aims to reduce drug misuse and its harms by increasing awareness among young people and parents. Information on synthetic opioids and the danger of their misuse is available at the following link:

https://www.talktofrank.com/drug/synthetic-opioids

Education on drug use is also a statutory component of relationships and sex education and health education in England. The Office for Health Improvement and Disparities and the Department for Education have commissioned lesson plans and other resources to support teachers in delivering quality drug prevention interventions. The lesson plans target primary and secondary students, teaching them how to manage influences and pressure, and keep themselves healthy and safe. These resources are being updated, and will have an increased emphasis on the risks of synthetic drugs.

The Department is actively monitoring, and responding to, the continued threat posed by the growing levels of potent synthetic opioids in the United Kingdom. We are working to increase awareness of the dangers of synthetic opioids. The Government’s drug information and advice service, Talk to FRANK, aims to reduce drug misuse and its harms by increasing awareness among young people and parents. Information on synthetic opioids and the danger of their misuse is available at the following link:

https://www.talktofrank.com/drug/synthetic-opioids

Education on drug use is also a statutory component of relationships and sex education and health education in England. The Office for Health Improvement and Disparities and the Department for Education have commissioned lesson plans and other resources to support teachers in delivering quality drug prevention interventions. The lesson plans target primary and secondary students, teaching them how to manage influences and pressure, and keep themselves healthy and safe. These resources are being updated, and will have an increased emphasis on the risks of synthetic drugs.

Guidance from England’s Chief Medical Officer for healthcare professionals is clear, an alcohol-free childhood is the healthiest and best option. The Department promotes this through online platforms such as the NHS.UK website, and the Talk to FRANK online resource. Local authorities promote these guidelines as part of their public health duties.

The Department for Education’s statutory guidance, Relationships education, relationships and sex education and health education, became mandatory in September 2020. Through this, education on drugs, alcohol, and tobacco became compulsory at state-funded primary and secondary schools, teaching children and young people how to manage influences and pressures, and keep themselves healthy and safe.

To deter individuals selling alcohol to a person aged under 18 years old, the maximum fine for the offence of persistently selling alcohol to children was increased from £10,000 to £20,000, under s 147A(8) of the 2003 Licensing Act.

The Government takes a wide-ranging approach to addressing alcohol-related harms, including through taking forward the commitments set out in Advancing our health: prevention in the 2020s, to increase the availability of no- and low-alcohol alternatives, establish alcohol care teams in the 25% of acute hospitals in England with the greatest need as part of the NHS Long Term Plan, and improve the alcohol and drug treatment system through the 10-year Drug Strategy.

The Department meets regularly with alcohol charity representatives, at a ministerial and official level, and is content to continue to do so, to support and inform our work in tackling alcohol related health harms.

The health advice is clear, if you don’t smoke, don’t vape, and children should never vape. Vaping can play a role in helping adult smokers to quit, but the number of children using vapes has tripled in the past three years, and a staggering 20.5% of children had tried vaping in March to April 2023

Drugs education is a mandatory component of the Relationships and Sex Education and Health Education curriculum taught in schools. The Office for Health Improvement and Disparities has commissioned the PSHE Association to publish teaching resources for schools on drug and alcohol use, and vaping. These resources are in the process of being updated, and there will be increased emphasis on the risks of synthetic drugs, including vapes.

Information on the dangers of using THC vapes is available on FRANK, the Government’s drug information and advisory website, which signposts users to support services and provides an around the clock and free-to-use confidential helpline, text and email message services, and an online chat.

Where there are incidents of synthetic cannabinoids in THC vapes, it is for the local authority public health team and the police force to take appropriate actions to warn and protect their at-risk populations, supported by regional teams.

There are eight NHS inpatient detoxification units in England. They are listed below:

Guys and St Thomas NHS Trust (London),

Bridge House, Kent and Medway NHS Trust (Maidstone, Kent),

Dame Carol Black Unit, Midlands Foundation NHS Trust (Fareham, Hampshire),

Acer Unit, Avon & Wiltshire Mental Health Partnership NHS Trust (Bristol),

Edward Myers Unit, Staffordshire Combined NHS Trust (Stoke),

New Beginnings, Rotherham, Doncaster, South Humber Foundation NHS Trust (Doncaster), Chapman Barker Unit, Greater Manchester Mental Health NHS Trust (Manchester),

Topaz Ward, Essex Partnership NHS Trust (Chelmsford, Essex).

Dame Carol Black’s review of evidence related to drugs, published in February 2020, estimated the cost to the National Health Service of illegal drug use at £431 million per annum. This includes admissions in secondary care, prison treatment and infectious disease. However, this figure does not include other NHS costs such as primary care or accident and emergency usage so will be an underestimate.