Tracking trends in illegal drug use is inherently difficult. After all, dealers don’t exactly publish annual reports, and users are understandably wary about researchers with clipboards asking probing questions.
Still, there are other ways of finding out what's going on: it turns out hospitals keep surprisingly detailed records of the number of diagnoses linked to various types of drugs – so I dug into the latest data. Here's what I learned.
Drug-related diagnoses are on the rise
Hospital diagnoses linked to illegal drugs have risen dramatically in the last five years, increasing by 65 percent since 2013. All classes of illegal drugs, apart from volatile solvents, saw significant increases in the total number of diagnoses at hospitals in England. That's counting both primary and secondary diagnoses – so includes patients whose main reason for being in hospital wasn’t drug related. But records for primary diagnoses also showed major increases for several classes of drugs, including cocaine, cannabinoids and hallucinogens. Steve Moffatt, public policy manager at the drug and alcohol charity Addaction, says hospital staff might be getting better at recording drug-related conditions, but that's unlikely to account for such a significant increase in the figures.
Hospital admissions for cocaine have rocketed
Cocaine-related diagnoses have more than doubled in the last five years, rising by 138 percent, the largest increase of any class of drug. This follows a steep rise in the use of the drug in England and Wales, most notably among young people, over the last decade. The total number of admissions linked to cocaine rose to 20,296 in 2017/18, an increase of 23 percent in just 12 months. Men are more than two-and-a-half times more likely than women to be diagnosed with conditions linked to cocaine. However, cocaine-related hospitalisations are rising faster among women – up more than 150 percent in the last five years.
Professor Adam Winstock, a consultant psychiatrist and founder of the Global Drug Survey, says: "The thing that's driving it is record production of cocaine in Colombia. Because there’s so much about, purity has gone up. With a better quality drug it’s easier to take too much."
Cocaine-related conditions are rising fastest among older people
Users aged between 30 and 34 are the most likely group to be hospitalised with a condition linked to cocaine. But cocaine-related diagnoses are rising fastest among the older generation, peaking in the 50 to 54 age bracket, which has seen a massive 217 percent rise since 2013. Overall, the mean age of patients with cocaine-related conditions has risen from 34 to 36 in the last five years. That might reflect a generation of coke users who are refusing to slow down. "The generation doing pills and coke in the 80s are now in their forties and fifties and still want to go out, but when they do they probably tend to overuse," says Winstock. "They're not 18 anymore, but after two or three pints maybe they think they are."
In fact, hospitalisations for older people are rising fast among most drug groups
You can see this trend most clearly in records for opioid-related diagnoses. The number of these has fallen among all age groups between 10 and 35 in the last five years – and risen among all age groups over 35. "It's very rare these days to see an 18 to 19-year-old, or even someone in their twenties, coming in to seek treatment for heroin," says Winstock. The increase in diagnoses among older people can be partly attributed to the general increased likelihood of health problems in older age. But there may also be other factors at play. "All the wraparound social services that were invested in heavily 20 years ago have been slashed," says Winstock.
Cannabinoids are a rapidly increasing health problem
Cannabis is one of the oldest recreational drugs on the planet, but cannabinoid-related hospital admissions have been rising faster than any other class of drug except cocaine (and among patients admitted for multiple drug use). The number of diagnoses rose more than 14 percent year-on-year and have gone up by 80 percent since 2012/13. That could be down to changes in cannabis production, says Moffatt: "Over the last few years, cannabis has just got stronger." It could also reflect greater numbers of users recognising they have a problem, says Winstock: "An awful lot of people get dependent on weed, and people are waking up to the fact they need help."
It's unclear to what extent the figures include users of synthetic cannabinoids, such as Spice and Black Mamba, which tend to produce much more significant side effects than herbal cannabis and are widely used in prisons and by homeless people.
There’s been a spike in admissions for teens taking sedatives
An investigation by VICE found the benzodiazepine Xanax is increasingly being used by teenagers. Children and teenagers showed the second most significant increase in sedative-linked conditions, with the number of admissions among 15 to 19-year-olds up 80 percent since 2013. While the older age group were most likely to be diagnosed with dependence issues, teens are more likely to be admitted for acute intoxication or harmful use. Moffatt says older people may be developing addictions after being prescribed sedatives, whereas it seems likely teenagers are using them recreationally.
"For a lot of substances, young people know about harm reduction," he says. "That might be less so the case with certain sedatives. A lot of young people will know the dangers of MDMA, but with Xanax they don’t know about the dangers to the same extent."
Still, alcohol-related diagnoses are falling for every age group between five and 50
So that’s something.