Alcohol & Drugs

All drug use increases the risk of harm – to the individual, those around them, and to wider society. Drug use includes illegal substances such as cannabis, ketamine, cocaine and heroin, as well as the misuse of legal substances such as prescription and over-the-counter medications. Alcohol is also a drug – it is a central nervous system depressant, meaning it slows down brain function and neural activity. The misuse of alcohol can cause significant problems including physical, psychological and social harm to the user, and to those around them (e.g. family, friends and the community). Drug and alcohol harm is multi-faceted, and every drug has a different harm profile.

Initially, people experiment with drugs or alcohol for a variety of reasons: for example, out of curiosity, because of peer pressure or out of rebelliousness, and this typically occurs at a young age. Up to half of young people may have experimented with illegal drugs or solvents by the time they are 16. Continued use of drugs occurs for many reasons, for example, relaxation, to become intoxicated, for pleasure, escapism, to lose inhibitions, enhance socialising, to self-medicate and relieve pain, to improve mood, or in some cases to relieve cravings linked to dependence.

Poverty, economic inactivity, and social deprivation are significant factors that can contribute to substance use.  People with pre-existing mental health conditions, including anxiety and depression, are particularly at risk (Source: RSPH, Taking a New Line on Drugs).

For the individual possible impacts of drug and alcohol use include dependence, a wide range of physical and psychological health impacts (e.g. cancer, cirrhosis, heart disease, psychosis, paranoia, anxiety, depression), and premature death. Drug and alcohol use can be linked to the loss of relationships, as well as tangibles such as housing and employment. For the family and friends of people that use substances there is increased risk of injury through mechanisms such as foetal harm, transmission of blood borne viruses, domestic violence, and road traffic collisions. For wider society there is harm from crime, economic costs (such as healthcare costs, loss of workforce productivity) and disruption to community cohesion (Source: Nutt et al. 2010). For all these reasons and more, tackling drug and alcohol use is a national priority.

The societal cost of harmful drinking is estimated at £27 billion a year, with 10.8 million adults drinking at levels which pose some risk to their health (Source: Institute of Alcohol Studies) . Similarly, the estimated costs of drugs to society is over £20 billion (Source: National Crime Agency) – more than twice the value of the market itself (Source: Department of Health & Social Care). The UK low risk drinking guidelines reflect a level of alcohol consumption that minimise health harms, and harms to family, friends and wider society. (Source: NHS).

• The National Government Drug Strategy – From harm to hope focusses on three themes: breaking drug supply chains; delivering a world-class treatment and recovery system; and achieving a generational shift in demand for drugs. The strategy aims to reduce drug-related crime, deaths, harms and overall drug use between 2022 and 2032.
• The Misuse of Drugs Act 1971 controls the use and distribution of dangerous and harmful drugs, with the aim of preventing drug misuse.
• The Psychoactive Substances Act 2016 defines and contains provisions for offences relating to, and provisions for, dealing with psychoactive substances.
• Drug misuse and dependence is the UK guideline on the clinical management of drug misuse and dependence. The guidelines are used by clinicians providing treatment for individuals using, or who have a dependence on drugs.
• Relevant NICE guidelines:
  • Alcohol-use disorders: diagnosis, assessment and management of harmful drinking (high-risk drinking) and alcohol dependence [CG115] which covers identifying, assessing and managing alcohol-use disorders (harmful drinking and alcohol dependence) in adults and young people aged 10-17 years. It aims to reduce harms (such as liver disease, heart problems, depression and anxiety) from alcohol by improving assessment and setting goals for reducing alcohol consumption.
  • Drug misuse prevention: targeted interventions [NG64] which covers targeted interventions to prevent misuse of drugs, including illegal drugs, ‘legal highs’ and prescription only medicines. It aims to prevent or delay harmful use of drugs in children, young people and adults who are most likely to start using drugs or who are already experimenting or using drugs occasionally.
• The Lincolnshire Drugs Strategy 2021-25 provides a local response to the national strategy.
• Core20PLUS5 is the NHS England and NHS Improvement approach to supporting a reduction in health inequalities (HI) at National and the System level.

General

Economic inactivity in Lincolnshire is higher than the England rate, while the average salary for the working age population of Lincolnshire is lower than in England (Source: ONS, 2024; NOMIS, 2025). Significant pockets of deprivation can be found in both urban and rural areas of the county which are exacerbated by relatively poor transport and internet infrastructure.  Areas of highest deprivation in Lincolnshire also have higher rates of people using illegal substances. Alcohol use in Lincolnshire, however, does not follow the same trend where increasing deprivation is not linked to increased alcohol use.

Alcohol

Nationally, 1 in 4 adults regularly drink over the Chief Medical Officer’s (CMO) low-risk guidelines (14 units per week). 27% of drinkers binge drink (6+ units for women, 8+ units for men) on their heaviest drinking days. Only 20% of the population report not drinking at all (Source: Alcohol Change UK).  Local data on alcohol consumption in Lincolnshire remains limited; however, we can gain valuable insight from a primary care perspective from Population Health Management (PHM) data. In 2024, 25% (203,646) of GP-registered patients underwent an alcohol assessment, revealing that 1% (8,344 individuals) were identified as drinking alcohol at hazardous levels. Additionally, over the last two years 2.3% (19,305 individuals) were recorded as consuming alcohol above the Chief Medical Officer’s low-risk guidelines (Source: Lincolnshire Integrated Care System (ICS)). The actual prevalence of excessive alcohol consumption in Lincolnshire is likely far higher than indicated by primary care data alone.

Generally, hospital admissions related to alcohol are lower in Lincolnshire than England averages – for the reporting year 2023-24:

• Alcohol-related hospital admissions in Lincolnshire (1,645 per 100,000) were below the England average (1,824 per 100,000) or the East Midlands average (1,773 per 100,000). The 5-year trend, however, is increasing both for males and females.
• Alcohol-specific hospital admissions in Lincolnshire (445 per 100,000) were below the England average (612 per 100,000) and the East Midlands average (534 per 100,000), and, the trend is worsening for males and females.
• Admissions for alcohol-related unintentional injuries in Lincolnshire (52.3 per 100,000) was lower than the England rate (61.6 per 100,000) and the East Midlands rate (58.8 per 100,000) signifying an increase back to the pre-covid rates.
• Admissions for mental and behavioural disorders due to the use of alcohol were lower in Lincolnshire (281 per 100,000) than the England average (393 per 100,000) or the East Midlands average (329 per 100,000) but showing an increasing trend for all persons, particularly for women.

(Source: OHID):

Whilst alcohol consumption patterns do not follow typical deprivation patterns, alcohol related harm disproportionately affects people from more deprived areas. (Source: Understanding the alcohol-harm paradox: what next? – The Lancet Public Health). The alcohol harm paradox suggests that while volume and frequency of alcohol use may not differ by deprivation, those with low individual or neighbourhood socioeconomic status (SES) show a greater susceptibility to the harmful effects of alcohol, compared to those with high SES. Relative to high SES, low SES is associated with an increased risk of head and neck cancers, strokes, hypertension, liver disease and pre-term birth. These factors are independent of several other known risk factors for these conditions such as diet and smoking.

In 2023, there was a total of 400 alcohol-related deaths in Lincolnshire, a rate of 46.5 per 100,000 population. Compared to England, Lincolnshire has a significantly higher rate of alcohol-related deaths but shares a similar rate to its neighbours in the East Midlands. Lincoln has the highest mortality rate at 64.3 per 100,000 population; this is significantly worse than the East Midlands and other Lincolnshire districts. Boston also has a high rate of mortality at 50.8 per 100,000 but the other districts in Lincolnshire are in line with the regional and national averages. (Source: OHID)

There are a range of ‘harms to others’ linked to the use of alcohol. For example, alcohol-related crime and anti-social behaviour has increased in adults compared to pre-pandemic levels in Lincolnshire. Many violent offences occur at night, particularly at weekends, in the early hours of the morning. Alcohol is a factor in 44% of night-time offences; drugs are a factor in 7% of incidents (Source: A Public Health Approach to Violence Reduction in Lincolnshire: A Strategic Needs Assessment).

In 2023/24 around 17.4% of the estimated number of adults who are alcohol dependent in Lincolnshire accessed specialist treatment services. Those wanting to access structured treatment for alcohol waited less than three weeks for treatment to commence and 296 people completed treatment successfully. (Source: National Drug Treatment Monitoring System (NDTMS).

There is no recent local data on the prevalence of alcohol use among children and young people (CYP). Nationally in 2023, 37% of school pupils reported having ever had an alcoholic drink. An average of 7% of children aged 11-15 years report usually drinking at least once a week, rising from 2% of 11 year olds – to 16% of 15 year olds (Source: NHS England).

In the period between April 2023 and March 2025, 5 young people in Lincolnshire received an alcohol-related criminal conviction (e.g. drunk and disorderly, or a motoring offence). This can only represent the tip of the iceberg as many young people are convicted of offences where alcohol influenced their behaviour but is not recorded in their conviction. In addition, 22 alcohol-related offences were managed through the youth justice Joint Diversionary Panel over the same period.

Drugs

Nationally, cannabis is the most used illicit drug with 6.8% of people between the ages of 16 to 59 years. 2.1% used powdered cocaine and 0.5% used opiates. Approximately 340,000 individuals in England are dependent on opiates and/or crack cocaine. The Home Office’s wastewater analysis in 2023/24 estimated that national cocaine and ketamine consumption had increased, by 7% and 85% respectively. However, heroin consumption is estimated to have decreased by 11% (Source: National Strategic Assessment (NSA) 2025 – Drugs – National Crime Agency)

During 2019/20 in Lincolnshire, an estimated 362 people used crack; 2,503 used opiates; and 3,720 were opiate and/or crack users (OCU). These figures should be treated with caution as they are now dated; nevertheless, they are the latest published statistics at local, regional and national levels (Source: NDTMS – ViewIt – Adult).

It is estimated during 2023/24 that 50% of adults in Lincolnshire using opiates and/or crack were in contact with specialist treatment services. There were 205 successful adult completions of drug treatment during the same year. Since 2016 there have been declining numbers of people engaged with the specialist service for opiate treatment only, but increasing numbers accessing treatment for both opiate and crack use (Source: NDTMS – ViewIt – Adult).

Dual diagnosis, where people experience severe mental ill health and drug or alcohol use problems together, is a challenge in Lincolnshire. Certain groups are more likely to experience dual diagnosis, for example, the homeless or those at risk of rough sleeping, and young people leaving care. To illustrate, almost half of young people leaving care in Lincolnshire have coexisting mental health difficulties and drug or alcohol needs.

Lincolnshire has several ethnic minority groups including non-British white, Black, Asian and Traveller and Gypsy communities, with more non-British white people living in the Boston area than anywhere else in the county.  These groups are proportionately represented in the treatment service. (Source: NDTMS – ViewIt – Adult).

Local data on drug use among CYP is scarce. However, national data reports a fall in the prevalence of lifetime and recent illicit drug use. In 2021, 18% of CYP reported ever taking drugs, falling to 13% in 2023. 5% reported drug use in the last month, compared with 6% in 2021 (Source: NHS England).

During 2023/24 there were 234 young people receiving treatment in Lincolnshire. Most referrals come from education or Children and Family Services. Most children in contact with the specialist service use multiple substances; the 4 most common being cannabis (86%), alcohol (44%), cocaine (17%) and ecstasy (14%). The number of young people accessing specialist treatment in Lincolnshire has increased in recent years (Source: NDTMS – ViewIt – Young People).

The harm from drugs is rising, with drug-related deaths in the UK increasing by 15% in 2023. Heroin continues to be associated with the largest number of deaths, followed by cocaine and benzodiazepines. Cocaine-related deaths increased by 30% in England and Wales (from 857 in 2022 to 1,118 in 2023) and by 29% in Scotland (from 371 in 2022 to 479 in 2023) (National Crime Agency: Strategic Assessment 2025).

According to the Office for National Statistics the drug related deaths rate was higher in Lincolnshire than England for both males and females for the period 2021-22 to 2022-23. Possible explanations could include an ageing cohort of people that use drugs, new trends in taking specific drugs, polydrug use, increasing risks of overdose, or increased cocaine use (Source: Safer Lincolnshire Partnership Update, 2023). The recent increased use of potent, contaminated opioids is increasing the risk of fatal overdose.

Synthetic opioids are an emerging trend in the UK and have been seen in the local drug market. These are substances that are synthesized in a laboratory and that act on the same targets in the brain as natural opioids (e.g. morphine and codeine) to produce analgesic effects.  Illicitly produced synthetic opioids are more potent than morphine and heroin thus have the potential to result in a fatal overdose. Nitazenes are a diverse group of synthetic opioids, and with over 500 known fentanyl analogues of varying potency have been a contributor in drug-related deaths in England since 2017, with spikes specifically noted in 2021 and 2023 (Source: House of Commons Library: What are synthetic drugs?). The number of nitazene related deaths is expected to grow as testing becomes more refined and deaths are more accurately recorded. Recent national data reported 125 nitazene-related deaths between July and December 2023, 200 between January and June 2024, and 133 between July and December 2024 (Source: NSA 2025 – Drugs – National Crime Agency).

Drug and alcohol use is a local priority, and significant work has been undertaken across the system where we are building a good understanding of local intelligence and securing supplemental funding to promote prevention and improve the treatment and recovery service.

Substance use is recognised as a complex, system-wide concern requiring co-ordinated action. Lincolnshire’s approach to drugs and alcohol is led by the Lincolnshire Drug and Alcohol Partnership. This multi-agency group is a collaboration of stakeholders who work together to deliver strategic priorities of prevention, treatment and recovery, and enforcement and offender management, aligned with the national drugs strategy  From Harm to Hope.

A key partner to the Drug and Alcohol Partnership is the Safer Lincolnshire Partnership (SLP). The SLP is Lincolnshire’s Community Safety Partnership, with a statutory duty to combat substance use within its broader remit to improve community safety across the county.

In Lincolnshire the drug and alcohol treatment and recovery services are currently provided by Lincolnshire Recovery Partnership (LRP), which is a partnership delivered by Turning Point, Double Impact and Framework Housing.  Lincolnshire Recovery Partnership (LRP) provides drug and alcohol treatment and recovery services for adults, a specialist service for children and young people, Horizon | Lincolnshire, and a service to specifically support family and friends of those who use substances, Beacon | Lincolnshire.

Lincolnshire Recovery Partnership provides advice, brief interventions, and longer-term structured treatments for people that use drugs and alcohol across the whole county. They offer psychosocial and pharmacological interventions, harm minimisation (including a needle syringe programme), prevention education, and support for sustainable recovery.  For individuals wanting support post-treatment or to maintain a drug/alcohol free lifestyle, the service offers recovery support experts by experience. Lived experience, alongside peer support and education, builds sustainable recovery capital and positions people in the best possible situation whilst emerging from problematic substance use.

Horizon offers a peripatetic service or children and young people that need support around drug and alcohol use.  They offer preventative education and work with young people to increase resilience through age-appropriate sessions.

Beacon offers support for family and friends of people that use substances. This is independent to the treatment service and there is no expectation that their family member or friend is engaged with LRP. Through one to one, group-based activities and bespoke support the service aims to equip families with the knowledge, tools and emotional resilience needed to navigate the impact of substance use and focus on their own wellbeing. They offer advice and guidance around any effects people may be experiencing including stress, anxiety, isolation and the impact to mental or physical health, relationships and finances.

Lincolnshire Recovery Partnership works closely with Lincolnshire Partnership Foundation Trust (LPFT) supporting people with dual diagnosis. There is a joint-funded Mental Health Liaison Service to provide specialist support to this cohort which includes LRP recovery workers co-located with mental health teams and LPFT mental health workers holding clinics in LRP resource sites. Horizon works in partnership with Future4Me supporting young people who access the youth offending service. Inpatient rehabilitation and detox are available when clinically indicated. LRP also provide training to individuals and community groups in the use of Naloxone – a life-saving antidote for opiate overdoses.

Community Alcohol Partnerships (CAPs) have been established in Boston, Spalding and Skegness, bringing together local councils, police, retailers, schools, and community groups to reduce the alcohol related harm of young people, improve health and wellbeing and enhance local communities. Workstreams have included ‘Challenge 25’ campaigns and training; raising the profile of public health, and encouraging diversionary activities.

One You Lincolnshire (OYL) provide support to people aged 18+ who drink 14 or more units per week and would like to make changes to their drinking. OYL offer one to one health coach sessions, a ‘drink less’ app, and virtual workshops.

Lincolnshire Police continue to develop ways to support people that use substances in Lincolnshire. This includes an out of court disposal offer which provides an alternative consequence to people accused of committing an offence related to drugs or alcohol, diverting them to support through LRP. Lincolnshire Police also continue to support people through the Integrated Offender Management (IOM) programme in collaboration with probation and LRP, have committed to supporting officers who want to volunteer to carry lifesaving Naloxone, and work hard to tackle county lines gangs.

The Stay Safe Partnership brings together organisations and voluntary agencies to deliver age-appropriate safety workshops, staff training, e-learning and online resources in schools across Lincolnshire. As part of this, Lincolnshire County Council (LCC) fund LRP staff to deliver drug and alcohol education to all schools in Lincolnshire. During the academic year 2023-2024 over 21,000 secondary school pupils and over 4,000 Year 6 pupils were engaged across the county.

Key partners include Lincolnshire Police, HM Prison and Probation Service, The Office of the Police and Crime Commissioner, District Councils, Lincolnshire County Council (Adult Care, Children’s Services, Coroner’s Office, Trading Standards), Lincolnshire Recovery Partnership, the Lincolnshire Integrated Care Board (ICB), Primary Care, Lincolnshire Partnership NHS Foundation Trust, Lincolnshire Community and Hospitals NHS Group, the Office for Health Improvement and Disparities (OHID), The University of Lincoln and other education providers.

Local services are committed to engaging with the public during the review and development of service pathways and policies which may include specific workshops where appropriate. Service user feedback is gathered through anonymous forms to ensure openness and honesty. This feedback is collated and published alongside action plans that outline how these insights will inform service improvements.

• Improving the response to the threat from synthetic opioids, by having a local intelligence system to report non-fatal overdoses, will ensure timely and accurate advice can reach those who need it quickly.
• Expanding the naloxone education and training programme to all service users, including young people, their families and professionals will widen the lifesaving response to overdose risk.
• Understanding why there are declining numbers of opiate users presenting for treatment for the first time, and developing plans to increase this will help to reduce short- and long-term risks for people that use opioids.
• Ensuring the needle and syringe programme is available to all people that inject drugs, and providing holistic harm reduction interventions at every contact will help to reduce harms caused by injecting behaviour.
• Ensuring specialist treatment services for young people consider specific needs of different groups, including gender and age, when designing programmes will ensure the service is attractive and relevant to all young people.
• Developing a programme of preventative alcohol work, ensuring interventions are focused on places where the need is greatest and are tailored to specific cohorts (e.g. younger adults and those aged 40-70), will encourage more people into structured treatment.
• Considering the impact of substance use on family and affected others and ensuring there is an opportunity for awareness, education and support at an early stage will equip individuals with the knowledge, tools and emotional resilience to navigate the impact of substance use on their health and wellbeing.
• Delivering specialist support in hospitals will ensure that interventions are available when needed, and individuals are supported into structured treatment if appropriate.
• Increasing awareness across the health and care system, of the impact of alcohol and drug use on a wide range of health conditions, and using this awareness to increase uptake of prevention and early intervention initiatives will reduce future system demand.

• Develop Lincolnshire’s Drug and Alcohol Strategy and ensure it has a balanced focus on both drug and alcohol use, supporting adults and young people in line with the three core priorities of the national strategy.
• There is evidence to suggest that substance use in Lincolnshire is changing and several different population subgroups are being affected in various ways. A comprehensive approach to prevention should be considered to minimise harms at primary, secondary and tertiary levels.
• Promote a partnership approach across the whole system that improves pathways for individuals to navigate services with ease, increases awareness and engagement with those that are not in contact with specialist treatment and reduces stigma.