The expert group updating the UK guidelines for the clinical management of drug misuse and dependence consists of a broad spectrum of stakeholders, including practising clinicians, pharmacists, service users, carers, psychologists, commissioners and academics. Each is required to complete a declaration of interests and keep this updated.

Public Health England, which provides the secretariat for the group, has reviewed these declarations and on the basis of the information provided believes that no expert group members have a financial interest in the prescribing of specific medicines for the treatment of dependence.

Clinicians’ declarations will be published alongside the updated clinical guidelines by early 2016.

Public Health England, on behalf of the United Kingdom Government and the devolved administrations, has convened an expert group with responsibility for updating the UK guidelines for the Clinical Management of Drug Misuse and Dependence.

In updating the clinical guidelines the Expert Group will be looking at all the available evidence, including reports from the Recovery Committee of the Advisory Council on the Misuse of Drugs.

The information requested is not collected centrally.

Data on the proportion of people receiving medicines is not held centrally; the National Drug Treatment Monitoring System (NDTMS) collects data on patients who receive prescribing interventions in a range of settings, but not which drugs they are prescribed.

The Health and Social Care Information Centre publishes data on the number of prescriptions dispensed in the community and in 2012-13 just less than three million prescription items containing either methadone or buprenorphine were dispensed through primary care facilities.

In addition to methadone and buprenorphine, which are recommended by the National Institute for Health and Care Excellence (NICE) for treating drug misuse, drug treatment should always involve evidence based psychosocial interventions. These psychosocial interventions are designed to treat drug misuse and help drug misusers achieve specific treatment goals. They are the mainstay of treatment for the misuse of cocaine and other stimulants, and for cannabis and hallucinogens.

People receive prescribing and psychosocial interventions in different settings, and these are recorded by the National Drug Treatment Monitoring System (NDTMS) as;

— Community;

— Primary Care;

— Inpatient Unit (prescribing in this setting is mostly for detox);

— Residential rehab; and

— Recovery House.

The NDTMS data which shows how many people received psychosocial interventions and prescribing in each of these settings, broken down into the four public health regions is in the following table.

Table 5.2.3: Interventions received by clients in treatment 2012-13, new interventions

* This is the total number of individuals receiving each intervention type and not a summation of the psychosocial and prescribing columns.

Table 5.2.3 provides information on interventions commenced after the changes to the core dataset on 1 November 2012 (see section 1.5 for more detail on this change). It shows the number of clients who received each intervention by setting for interventions starting on or after 1 November 2012 based on the new intervention codes. If a client’s intervention features in Table 5.2.3, the same intervention (for interventions that can be directly mapped between tables) is not featured in Table 5.2.2 to avoid double counting.

The data requested is not collected centrally. However, the National Drug Treatment Monitoring System (NDTMS) collects data on people who have received a prescribing intervention, and can track if they re-enter the treatment system at a later date. The specific drugs they are prescribed or the prescribing intention is not recorded.

The following table below shows the numbers of people who indicated an opiate among their problematic substances and successfully completed treatment following a prescribing intervention, the numbers (of the above) who subsequently re-entered the treatment system within six months, and the numbers (of the above) who re-entered the treatment system indicating an opiate among their problem substances and then received a prescribing intervention.

It is important to note that since specific drugs prescribed are not recorded, we do not know which drugs were prescribed when the patient re-entered the treatment system. They may have been re-prescribed the same drug they were receiving before, or they may have been prescribed a different drug from the one they received before (e.g. they were receiving methadone, but received buprenorphine when they returned). It is also possible that they may have received prescribing for a different purpose when they returned to treatment. Some people who have received prescribing may return to treatment for support which does not involve prescribing.

The numbers recorded are those who received prescribing as part of any treatment pathway before they completed treatment, so may have been receiving a range of other interventions in different settings as part of their treatment journey (e.g. psychosocial interventions, residential rehabilitation and structured community based rehabilitation ).

Figures are presented for 2011 and 2012 calendar years. The figures for 2013 are not yet available.

The NDTMS dataset has been changed (effective from November 2012) to take better account of prescribing intentions, so now it records whether prescribing was intended for assessment and stabilisation, maintenance, withdrawal or relapse prevention.

This data is not collected centrally. The National Drug Treatment Monitoring System (NDTMS) collects data on patients who receive prescribing interventions in a range of settings, but not which drugs they are prescribed.