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

Dan Lewer; Sara Croxford; Monica Desai; Eva Emanuel; Vivian D. Hope; Andrew McAuley; Emily Phipps; Emily J. Tweed

doi:10.1111/add.15911

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

Dan Lewer^*, Sara Croxford, Monica Desai, Eva Emanuel, Vivian D. Hope, Andrew McAuley, Emily Phipps, Emily J. Tweed

^*Corresponding author for this work

UK Health Security Agency

Research output: Contribution to journal › Article › peer-review

8 Citations (Scopus)

11 Downloads (Pure)

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.

Original language	English
Pages (from-to)	2471-2480
Number of pages	10
Journal	Addiction
Volume	117
Issue number	9
DOIs	https://doi.org/10.1111/add.15911
Publication status	Published - 12 May 2022

Bibliographical note

Funding Information: Research Trainees Coordinating Centre, Grant/Award Number: DRF-2018-11-ST2-016; Medical Research Council, Grant/Award Number: MC_UU_00022/2; Chief Scientist Office, Grant/Award Numbers: CAF/17/11, SPHSU17; National Institute for Health Research, Grant/Award Number: DRF-2018-11-ST2–016

Open Access: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Publisher Copyright: © 2022 The Authors.

Citation: Lewer D, Croxford S, Desai M, Emanuel E, Hope VD, McAuley A, et al. 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. 2022;117:2471–80.

DOI: https://doi.org/10.1111/add.15911

Keywords

Ageing
United Kingdom
demography
epidemiology
heroin
injecting
modelling

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Cite this

@article{ba451c1d4b284ca7824241e2148f4c9b,

title = "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",

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.",

keywords = "Ageing, United Kingdom, demography, epidemiology, heroin, injecting, modelling",

author = "Dan Lewer and Sara Croxford and Monica Desai and Eva Emanuel and Hope, {Vivian D.} and Andrew McAuley and Emily Phipps and Tweed, {Emily J.}",

note = "Funding Information: Research Trainees Coordinating Centre, Grant/Award Number: DRF-2018-11-ST2-016; Medical Research Council, Grant/Award Number: MC_UU_00022/2; Chief Scientist Office, Grant/Award Numbers: CAF/17/11, SPHSU17; National Institute for Health Research, Grant/Award Number: DRF-2018-11-ST2–016 Open Access: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. Publisher Copyright: {\textcopyright} 2022 The Authors. Citation: Lewer D, Croxford S, Desai M, Emanuel E, Hope VD, McAuley A, et al. 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. 2022;117:2471–80. DOI: https://doi.org/10.1111/add.15911",

year = "2022",

month = may,

day = "12",

doi = "10.1111/add.15911",

language = "English",

volume = "117",

pages = "2471--2480",

journal = "Addiction",

issn = "0965-2140",

publisher = "wiley",

number = "9",

}

TY - JOUR

T1 - The characteristics of people who inject drugs in the United Kingdom:

T2 - changes in age, duration, and incidence of injecting, 1980–2019, using evidence from repeated cross-sectional surveys

AU - Lewer, Dan

AU - Croxford, Sara

AU - Desai, Monica

AU - Emanuel, Eva

AU - Hope, Vivian D.

AU - McAuley, Andrew

AU - Phipps, Emily

AU - Tweed, Emily J.

N1 - Funding Information: Research Trainees Coordinating Centre, Grant/Award Number: DRF-2018-11-ST2-016; Medical Research Council, Grant/Award Number: MC_UU_00022/2; Chief Scientist Office, Grant/Award Numbers: CAF/17/11, SPHSU17; National Institute for Health Research, Grant/Award Number: DRF-2018-11-ST2–016 Open Access: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. Publisher Copyright: © 2022 The Authors. Citation: Lewer D, Croxford S, Desai M, Emanuel E, Hope VD, McAuley A, et al. 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. 2022;117:2471–80. DOI: https://doi.org/10.1111/add.15911

PY - 2022/5/12

Y1 - 2022/5/12

N2 - 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.

AB - 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.

KW - Ageing

KW - United Kingdom

KW - demography

KW - epidemiology

KW - heroin

KW - injecting

KW - modelling

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