Triaging London’s Drug Problem

One need not walk too much to find a human being intoxicated by substances, laying in, or slowly staggering through, the streets of London. This article will cover the provision of addiction services, specifically rehabilitation centers, in London as a public service, while considering the rates and trends of substance misuse.

Characterizing the Problem

Figure 1. Comparison of cocaine use per day in London compared to Berlin, Amsterdam, and Barcelona. Visualization by Armstrong (2019)

This article will focus on illicit substances, thereby excluding alcohol and nicotine from the analysis. London has been referred to as the ‘cocaine capital’ of Europe on account of the relatively high cocaine use relative to other major European cities (Figure 1). In 2019, the cocaine usage was approximately 560,000 doses per day. Fentanyl, an opioid several magnitudes more potent than heroin, has also made significant inroads in the London drug scene (Haynes, 2023). There were 477 deaths related to drug-poisoning in 2022, which is the lowest rate (56.6 deaths per million) relative to other regions in England and Wales (Office for National Statistics, 2023, December 19). However, the rate of drug-related deaths has been on an upward trend over the past decade within London (Figure 2). The Office for National Statistics (ONS) reported that 38% of users in England and Wales find it very or fairly easy to obtain illegal substances within 24 hours; this rate increases to 43% for people aged 16–24…