Rise in drug problems

 Hospitals’ Huge Rise in Drug Problems (01/05/07)

  • One newspaper article, published on 24th April 2007, was identified. The article focused on a purported rise in the number of people admitted to hospital with a mental illness related to drug use [1].
  • The information reported in the article was based on the Statistics on Drug Misuse: England 2007 [2] report produced by the Information Centre for Health and Social Care. The report is a statistical bulletin and compiles a range of data on drug misuse in England, which have been collated from a variety a sources. The report has three strands: drug misuse amongst adults, drug misuse amongst children, health outcomes related to drug misuse. The report details the prevalence of drug misuse amongst adults and highlights the types of substances most commonly used; the prevalence of drug misuse amongst children, examining the relationship between drug misuse and socio-demographic factors, and children’s knowledge and attitudes towards drug taking; and the health outcomes related to drug use including information on drug treatment, hospital admissions and mortality.
  • A number of errors were identified within the article titled ‘Hospitals’ Huge Rise in Drug Problems’.
  • The article reported that the number of people admitted to hospital with a mental illness triggered by drug abuse has tripled in ten years. However, the figure presented in the article refers to admissions where there was a secondary diagnosis of drug related mental health and behavioural disorders. Secondary diagnoses describe other conditions the patient may have and is therefore not the primary reason for admission. The number of admissions with a primary drug related health and behavioural disorder have actually remained relatively stable for the last ten years. The article does however quote Public Health Minister Caroline Flint explaining that ‘drugs were not the primary reason for these admissions’. Admissions with drug-related mental health and behavioural disorders include acute intoxication, harmful use (damage may be physical or mental), dependence syndrome, withdrawal state, withdrawal state with delirium, psychotic disorder, amnesic syndrome, residual and late on set psychotic disorder, other mental and behavioural disorders and unspecified mental and behavioural disorders (International Statistical Classification of Diseases and Related Health Problems, version 10; ICD-10 codes F11-16, F18 and F19, For more information please go to www.who.int) [3].
  • The article elaborates on the rise in the number of people admitted to hospital with mental illness triggered by drug abuse by reporting that ‘the increasing popularity of stronger strains of ‘skunk’ cannabis are to blame for much of the increase’. The Information Centre’s report does not provide any evidence to support this claim. Furthermore, a full breakdown of admissions for drug related mental health and behavioural disorders is not provided in the report in order for such an assumption to be made. However, research has indicated a link between cannabis and clinically relevant psychopathology [4], although further study is required. Finally, there is no evidence to suggest that the prevalence of use of ‘skunk’ has increased, and that high THC strains of cannabis are more likely to result in adverse mental health outcomes.
  • The article continues to discuss the relationship between drugs and mental health and states that ‘eighty percent of patients admitted to inner-city psychiatric wards are using illegal drugs’. Although it was not possible to locate published evidence to substantiate this statement, a news article was identified that claimed ‘almost half the patients in hospitals admitted to taking illegal drugs before admission, and of these, the great majority, 83%, admitted to drug use on the wards’ [5].
  • The article reports that the number of ‘cases involving spiked drinks and other ‘drug poisonings’ also rose by 50 per cent over the same period’ however the Information Centre’s report does not at, any point, refer to admissions for drug poisonings as admissions due to drink spiking. In addition, poisonings by drugs refers to poisonings by narcotics (e.g. opiates) and psychodysleptics (e.g. hallucinogens) and includes overdoses of these substances or wrong substances given or taken, and psychostimulants with abuse potential (ICD-10 codes T40.0-T40.9 and T43.6, for more information please go to http://www.who.int/). It excludes intoxication or pathological drug intoxication.
  • It is important to note that the figures provided by the Statistics on Drug Misuse: England 2007 report, refer to the number of hospital episodes, which are defined as a period of admitted care under one consultant within one healthcare provider. Consequently, the figures do not represent the number of patients, as a person may have more than one hospital episode per year.  
  • Some caution is necessary when examining hospital episode data as, drug misuse may only be suspected and may not always be recorded by the hospital, and where drug misuse is recorded it may not be possible to identify when drugs may be involved.

Title, Author and Source


Information Centre for Health and Social Care (2007) Statistics on Drug Misuse: England 2007. London: The Information Centre.


Available from: http://www.ic.nhs.uk/pubs/drugmisuse07

What were the Study Objectives?


The objective of the report is to provide an annual statistical bulletin, which presents information on drug misuse amongst adults and children, and health outcomes related to drug misuse. The report provides information on the prevalence of drug misuse, trends in drug misuse in recent years, patterns of drug misuse amongst different populations, European comparisons of drug misuse, drugs and crime, and health outcomes related to drug misuse.


What was the nature of the evidence?


The report presents data gathered from a range of sources. Most of the data has been published previously by the Information Centre, Department for Health, Home Office, Office for National Statistics, Health Protection Agency and many more.


What were the findings?


The report provides information drawn from a variety of sources and presents them in a statistical bulletin. It is entirely descriptive and documents the prevalence of drug misuse and health outcomes related to drug misuse. 


What were the conclusions?


The report was purely descriptive.


References


[1] METRO (24th April 2007) Hospitals’ huge rise in drug problems

[2] Information Centre for Health and Social Care (2007) Statistics on Drug Misuse: England 2007. London: The Information Centre. Link

[3] http://www.who.int/

[4] Forti DM, Morrison PD, Butt A and Murray RM (2007) Cannabis use and psychiatric and cognitive disorders: the chicken or the egg? Current Opinion In Psychiatry 20 (3):228-34

[5] BBC News (14th May 2006)  Illegal drugs 'common' on wards. Link
NCCDP, Centre for Public Health, Liverpool JMU, Castle House, North Street, Liverpool L3 2AY, UK