The characteristics of people who inject drugs in the United Kingdom: changes in age, duration, and incidence of injecting, 1980-2019, using evidence from repeated cross-sectional surveys

Lewer, D., Croxford, S., Desai, M., Emanuel, E., Hope, V. D., Mcauley, A., Phipps, E. and Tweed, E. J. (2022) The characteristics of people who inject drugs in the United Kingdom: changes in age, duration, and incidence of injecting, 1980-2019, using evidence from repeated cross-sectional surveys. Addiction, 117(9), pp. 2471-2480. (doi: 10.1111/add.15911) (PMID:35546310) (PMCID:PMC9544601)

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Abstract

Background and aims: Mortality and drug treatment data suggest that the median age of people who inject drugs is increasing. We aimed to describe changes in the characteristics of people injecting drugs in the United Kingdom (UK). Design: Repeat cross-sectional surveys and modelling. Setting: Low-threshold services in the United Kingdom such as needle and syringe programmes. Participants: A total of 79 900 people who recently injected psychoactive drugs in the United Kingdom, recruited as part of the Unlinked Anonymous Monitoring Survey (England, Wales, Northern Ireland, 1990–2019) and Needle Exchange Surveillance Initiative (Scotland, 2008–2019). Measurements: Age of people currently injecting, age at first injection, duration of injecting (each 1990–2019) and estimates of new people who started injecting (1980–2019). Findings: In England, Wales and Northern Ireland between 1990 and 2019, the median age of people injecting increased from 27 (interquartile range [IQR], 24–31) to 40 (IQR, 34–46); median age at first injection increased from 22 (IQR, 19–25) to 33 (IQR, 28–39); and median years of injecting increased from 7 (IQR, 3–11) to 18 (IQR, 9–23). Values in Scotland and England were similar after 2008. The estimated number that started injecting annually in England increased from 5470 (95% prediction interval [PrI] 3120-6940) in 1980 to a peak of 10 270 (95% PrI, 8980-12 780) in 1998, and then decreased to 2420 (95% PrI, 1320-5580) in 2019. The number in Scotland followed a similar pattern, increasing from 1220 (95% PrI, 740–2430) in 1980 to a peak of 3080 (95% PrI, 2160–3350) in 1998, then decreased to a 270 (95% PrI, 130–600) in 2018. The timing of the peak differed between regions, with earlier peaks in London and the North West of England. Conclusions: In the United Kingdom, large cohorts started injecting psychoactive drugs in the 1980s and 1990s and many still inject today. Relatively few people started in more recent years. This has led to changes in the population injecting drugs, including an older average age and longer injecting histories.

Item Type:Articles
Additional Information:D.L. is funded by the National Institute for Health Research (NIHR; Doctoral Research Fellowship DRF-2018-11-ST2–016).
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Tweed, Dr Emily
Authors: Lewer, D., Croxford, S., Desai, M., Emanuel, E., Hope, V. D., Mcauley, A., Phipps, E., and Tweed, E. J.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
Journal Name:Addiction
Publisher:Wiley
ISSN:0965-2140
ISSN (Online):1360-0443
Published Online:12 May 2022
Copyright Holders:Copyright © 2022 The Authors
First Published:First published in117(9): 2471-2480
Publisher Policy:Reproduced under a Creative Commons Licence

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
301147Morbidity and mortality among people experiencing severe and multiple disadvantage: a cohort study using cross-sectoral data linkageEmily TweedOffice of the Chief Scientific Adviser (CSO)CAF/17/11HW - MRC/CSO Social and Public Health Sciences Unit
3048231Inequalities in healthAlastair LeylandChief Scientist Office (CSO)SPHSU17HW - MRC/CSO Social and Public Health Sciences Unit
3048231Inequalities in healthAlastair LeylandMedical Research Council (MRC)MC_UU_00022/2HW - MRC/CSO Social and Public Health Sciences Unit