Review of the year – 2023

ddn magazine review of the drug treatment system in the uk 2023

While the money promised in the wake of the drug strategy continued to flow into the treatment system, there were disturbing shifts in the country’s constantly changing drug supply – with more highly potent synthetic opioids being entering the market than ever before.


In what could be an ominous sign of things to come on this side of the Atlantic, New York City’s health department attributes an almost 80 per cent increase in overdose deaths since 2019 largely to fentanyl. More than a million Americans have now died from a drug overdose since 2000, says the US Centers for Disease Control and Prevention. Meanwhile, the number of people being treated for alcohol issues in the UK is up by 10 per cent in a year, to almost 85,000, according to the latest OHID figures. 


ddn magazine february 2023More than £420m funding is confirmed for local authorities to provide drug and alcohol treatment through to 2025, part of the government’s commitment to significantly increase treatment capacity. The number of drug-free wings in prisons doubles to 45, with up to 100 special blocks planned by 2025, and DDN is devastated to hear of the death of harm reduction activist and long-time DDN conference team member Si Parry. 


ddn magazine may 2023The government announces that it intends to ban nitrous oxide, despite the ACMD advising that the harms associated with the substance are ‘not commensurate with control under the Misuse of Drugs Act’ and a ban would put ‘disproportionate burdens’ on its legitimate use. Meanwhile, global cocaine production increases by 35 per cent in just two years following a COVID-related slowdown, says UNODC. ‘The surge in the global cocaine supply should put all of us on high alert,’ says the agency’s executive director, Ghada Waly.


ddn magazine april 2023The much-delayed gambling white paper is finally published, with proposals including a mandatory levy on the industry to fund treatment and new stake limits for online slot games, although many are disappointed with the lack of action on advertising. 

A statement from 30 health organisations warns that Scotland could be ‘sleepwalking’ back to record levels of alcohol-related deaths, while the latest Home Office figures reveal that seizures of cocaine and ketamine are at their highest ever levels. 

Meanwhile, the first comprehensive census of the drug sector’s workforce shows there are now almost 11,500 ‘whole time equivalent’ treatment provider staff working alongside nearly 400 commissioning staff.


ddn magazine may 2023The government is ‘complacent’ about the scale of alcohol-related harm in the country, warns the House of Commons Public Accounts Committee, with a ‘staggering’ 82 per cent of dependent drinkers not receiving treatment. ‘The government has had no alcohol strategy in place since 2012 and abandoned its latest effort in 2020 – just as deaths from alcohol began to rise sharply over the terrible, unacceptable toll it was already taking,’ states committee chair Meg Hillier. 


ddn magazine june 2023Global drug markets are being transformed by ‘cheap and easy’ synthetic drugs, warns UNODC’s latest World drug report – with ‘lethal’ results. Synthetic opiates mean lower costs and fewer risks for traffickers, the report points out, with more and more now likely to enter the market as a result of the Taliban’s opium ban in Afghanistan. 

Some good news, however, in an update to the HIV action plan for England, which states that new HIV transmissions have fallen by a third since 2019. This means the country is on course to meet the target of an 80 per cent reduction in new transmissions by 2025, and an end to them by 2030. 


ddn july 2023Treatment agencies begin issuing warnings about unusually strong opioids, with clusters of fatal overdoses around the country. Drugs sold as heroin, oxycodone and ‘street benzos’ are being found to contain fentanyls and nitazenes, the organisations point out. 

DDN heads to Birmingham for its 15th annual service user conference, Many Roads. While it’s no longer socially acceptable to stigmatise people with mental health issues, Phoenix Futures chief executive Karen Biggs tells delegates, attitudes to people who use drugs still haven’t changed. 


OHID issues updated guidance for commissioners and services on preparing for incidents involving fentanyl and nitazenes, telling local areas that they need to plan how to ‘rapidly understand and assess’ the risks and minimise the impact – including by improving drug information systems and naloxone supply. Scotland’s latest drug death figures show a 21 per cent reduction, however, although the figure is still almost quadruple the level of 20 years ago. 

A report from the House of Commons Home Affairs Committee, meanwhile, says the 1971 Misuse of Drugs Act is outdated and in need of reform. ‘Whilst the drug strategy is moving in the right direction, it requires much more meaningful action to tackle the broad range of drug-related problems,’ says committee chair Dame Diana Johnson.


ddn september 2023Scotland’s lord advocate says it would ‘not be in the public interest’ to prosecute people for possession offences committed in a pilot drugs consumption room, opening the door for the introduction of legal pilot schemes. Two weeks later Glasgow approves the plan for a facility in the city’s east end, while Scotland also consults on raising the minimum unit price for alcohol to 65p – despite ongoing controversy over how effective the intervention has been so far.


ddn oct 2023The National Audit Office warns that the government will need to address a lack of focus on intervention, uncertainties around future funding, and gaps in the evidence base if it is to achieve its drug strategy ambitions. While more than 1,200 new drug and alcohol workers have already been recruited against a target of 950 by 2024-25, there are still delays in distributing drug strategy funding and implementing new projects. 

The government also announces ‘the most significant public health intervention in a decade’, with plans to raise the smoking age year-by-year to prevent anyone now younger than 14 from ever being able to legally buy cigarettes. 


ddn november 2023Opium poppy cultivation in Afghanistan has plummeted by 95 per cent since the Taliban’s opium ban, says the latest analysis by UNODC, fuelling fears of yet more fentanyl and nitazenes entering the drug market, while the Metropolitan Police recovers 150,000 nitazene tablets – the UK’s largest ever seizure of synthetic opioids – that are destined for sale on the dark web. 

The government’s controversial nitrous dioxide ban comes into force, while New Zealand’s plan to ban smoking for future generations – the model for the UK’s projected legislation – is promptly scrapped by the country’s new government. 

Meanwhile, new public health guidance from the European Centre for Disease Prevention and Control (ECDC) and EMCDDA classifies consumption rooms as one of the six key interventions to prevent infections among people who inject drugs. 

And finally, with a general election once again looming, Change Grow Live share their asks of a new government, including committing to sustainable three-year funding cycles, recognising the role of third-sector providers and publishing a comprehensive substance misuse workforce strategy. 


ddn december 2023At the turn of the year we hope for continued investment alongside stability and progress in the sector – and look forward to its favourite magazine turning 20 years old!


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