The report, a systematic review of largely publicly available evidence with ad hoc insights from Forward Trust’s operational delivery and practice, found there is no precise data on the true scale of addiction in the UK. But the picture created from existing data shows the problem is widespread and, in some areas, worsening, with an estimated:

• 750,000 people addicted to alcohol
• 400,000 people addicted to illegal drugs
• 700,000 people currently in recovery from addiction

Alcohol addiction alone costs the NHS an estimated £3.5 billion every year.

Drug poisoning deaths registered in England and Wales in 2024 were the highest since records began in 1993, substantially above figures from a decade earlier - equivalent to 93.9 deaths per million people and around a 1% increase from a rate of 93.0 deaths per million people in the previous year.

Researchers point to nitazenes, synthetic opioids that can be hundreds of times more potent than heroin, as a significant driver of this rise. One criminal justice team leader told researchers that since the drugs first appeared in 2021, they have seen users, in their words, "dancing with death." Another case study quoted: "It's in everything. You can't get away from it."

The report also identifies chronic ketamine use as a fast-growing area of harm. Presentations to treatment services for ketamine use are now 12 times higher than a decade ago, with illicit use rising most notably among school-aged children and university students.

Beyond the human toll, the report highlights that:

• People with substance use disorders are more likely to commit crimes than the general population — though this remains a minority of the addiction population
• Drug supply networks are closely linked to violence, exploitation, and drug-related homicides
• Addiction reduces employment and weakens people's contribution to the wider economy

The report authors call for the maintenance of reliable funding for the drug and alcohol treatment and recovery services in every area of the country. They encourage the growth of services that provide support for non-opiate drug use and alcohol addiction, which they argue is currently significantly under-resourced despite growing demand.