National Audit Office report on Reducing the harm from illegal drugs

The government’s 2021 drugs strategy has provided fresh impetus to the efforts to tackle harm to society from illegal drugs, but it will need to address uncertainties about future funding, gaps in the evidence base and a lack of focus on prevention, if it is to achieve its objectives, according to a National Audit Office (NAO) report¹.

The report – Reducing the harm from illegal drugs – assesses progress against the government’s 10-year strategy² which follows a surge in drug-related crime and deaths between 2011 and 2021. The government has committed £900 million for the first three years of the strategy, from 2022 to 2025, with £768 million to enhance treatment and recovery services. It has established 106 new partnerships with local areas across England, bringing together representatives from criminal justice and health sectors. However, government still faces significant challenges to address barriers to achieving a long-term reduction in drug use, deaths and related crime³.

The report highlights that the UK does not have an effective drug prevention system, with the government having committed almost £30 million to reducing long-term demand – 3% of the total funding for the drugs strategy to 2025 – compared to £105 million for disrupting supply. It calls for urgent action to develop a plan to reduce the demand for illegal drugs. The government does not yet have the evidence it needs to understand how to change behaviours and does not expect to develop new initiatives to tackle prevention until at least 2025.

The NAO recommends that the Joint Combating Drugs Unit (JCDU), which was established in 2021 to oversee implementation of this complex, cross-government strategy, strengthens its approach to evaluating the impact of funding. The report states that the JCDU has not established sufficient capacity to draw departmental evaluations together to understand the type of interventions that are effective, or the impact of projects at a local level.

In 2021 the government estimated that the harm caused by illegal drugs costs society £20 billion each year, with around 3 million people in England and Wales believed to take illegal drugs. Spending on adult drug and alcohol treatment services decreased by 40% in real terms between 2014-15 and 2021-22, with wide variations between local authorities - 42 out of 150 areas experienced falls of 50% or more. This contributed to a reduction in treatment services, the number of people being treated and skills shortages.

Government has committed funding for the first three years of the strategy. The lack of certainty after 2025 restricts the ability of local authorities to recruit and plan. The JCDU has begun to prepare for the 2025 Spending Review but has not developed a plan beyond that date.

Departments have made progress in some areas. For example, the Home Office has increased activity to reduce the supply of drugs and local government has recruited 1,224 new drug and alcohol workers, already exceeding the target of 950 new staff by 2024-25. However, delays in implementing projects and dispersing drug strategy funding led to a 14% underspend in 2022-23 and there has been slower progress recruiting medical, mental health and other professionals. At this stage, the JCDU does not know the extent to which the strategy is reducing the number of people who use illegal drugs⁴. 

The NAO concludes that government should work to understand the challenges to achieving the strategy’s 10-year aims.

The JCDU should provide confidence to local government that the government is committed to reducing the harm from illegal drugs in the long-term⁵, which is the only way the government will achieve value for money. It must set out how it plans to prevent illegal drug use, as well as addressing the supply and the consequences of illegal drugs.

Among its recommendations, the report calls on the JCDU to clarify roles and responsibilities, ensure limited resources are used in the most effective way, and agree with HM Treasury and other departments what is achievable before the next Spending Review.

Gareth Davies, the head of the NAO, said:

“The government has shown a clear commitment to reducing the harm caused by illegal drugs by establishing a cross departmental drugs strategy and committing £900 million in the first three years. But much work needs to be done ahead of the next Spending Review to ensure it understands how to develop its approach and achieve its long-term aims.

“Significant challenges remain, and the current lack of emphasis on preventing illegal drug use means that departments risk only addressing the consequences, rather than the causes, of harm. Government will only achieve value for money if it builds on the initial momentum of the new strategy and develops a longer-term, funded plan that delivers a joined-up, holistic response.”

ENDS

Notes for Editors

1. Government established three strategic outcomes to address the harm from illegal drugs relating to reducing drug use, reducing drug-related deaths and reducing drug-related crime.
2. From harm to hope committed £900 million for the first three years, from 2022 to 2025. Departments allocated £768 million to enhance treatment and recovery services; £105 million to disrupt the supply of illegal drugs and £30million to reduce long-term demand.
3. In 2021, before the latest strategy was unveiled, there were 2,846 deaths from drug misuse in England, an 80% increase since 2011, with a further 360 drug-related homicides in England and Wales in the same year, 58% higher than in 2011.
4. In May 2022, the Advisory Council on the Misuse of Drugs concluded that the UK did not have a functioning drug prevention system and that significant investment was needed to rebuild infrastructure and co-ordinate support across services.
5. Retaining staff has proved challenging, with the sector experiencing high levels of turnover – In 2022-23, turnover was 12% for NHS treatment providers and 27% in third-sector treatment providers. Across all providers, 37% of staff had been in post for less than a year.