When considering health, crime, family and societal costs, the estimated cost to society of illegal drugs in England and Wales is around £20 billion per year. Alcohol harm costs the NHS around £3.5 billion per year, with the cost to wider society estimated at £25 billion. There were around 8,500 individuals admitted into hospital in Wales with an alcohol-specific condition in 2022-23 and around 3,400 for illicit drug use. High quality treatment and support is the most effective way of improving outcomes for individuals at risk of harm from substance use. Substance misuse treatment aims to match individual needs and varies depending on the substance type (including alcohol and/or illicit drugs including opioids, stimulants such as cocaine, crack and amphetamine, cannabinoids and other drugs) and severity including: • harm reduction services • community-based programmes and structured psychosocial interventions • community prescribing delivered through specialist substance misuse teams or GP-led shared care • Inpatient detoxification and stabilisation programmes and residential rehabilitation for those requiring more intensive and acute.

An integrated care approach means that individuals should be able to access a combination of modalities as part of treatment. To date, no assessment of long-term substance misuse treatment outcomes has been conducted in Wales. Since substance misuse can be a relapsing condition, monitoring outcomes which could indicate a return to harmful substance use for people who have engaged with treatment is essential in assessing the effectiveness of these services in Wales. This Data Insight presents the findings of a study conducted as part of the BOLD Substance Misuse Demonstrator Pilot (Phase 1) in Wales, which focuses on substance misuse treatment effectiveness. Further information on the BOLD programme can be found here: Better Outcomes Through Linked Data (BOLD) This research, focussing on long-term outcomes for people treated for substance misuse in Wales, forms part of a wider study examining the predictors of individuals completing or not completing treatment in Wales in order to identify opportunities for improved engagement and more effective substance misuse treatment services.