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The Children's Society called for better education to alert potential victims to the risks of involvement with gangs offering drugs, alcohol and the false promise of status and wealth.
Chief executive Matthew Reed said while the report sheds light on the “shocking scale” of child grooming and exploitation by criminal gangs, the figures could be just the tip of the iceberg.
Once they gain control over the victim, whether through drug dependency, debt or as part of a relationship, dealers move in and the risk of domestic abuse, sexual exploitation and violence increases even further.
The NCA said that although drug users appear complicit the issue of “true consent” is questionable, with a fifth of police forces who found “cuckooing” also finding imprisonment and modern slavery seeing vulnerable people detained or denied access within their own home.
"The coercion of children into drug dealing is traumatic and puts them at great risk - they are often forced to carry drugs inside their bodies, and sent across the country to stay in 'trap houses' and sell drugs to dangerous adults.” Once gangs move into a target area, they use a practice known as “cuckooing” to set up bases in local homes or businesses, with three quarters of forces finding the exploitation of vulnerable people.
They use vulnerable adults including class A drug addicts, elderly people, disabled people and those with mental health issues, female sex workers and single mothers to operate out of their homes – operating several “cuckooed” bases at one time to evade detection.
"The stories we have heard from young victims of 'county lines' exploitation are horrifying and absolutely heartbreaking,” he added.
Officials said the actual figure could be far higher and that county lines are present in every police force area, with three quarters linking them to the exploitation of children and vulnerable people with mental or physical health issues.
London is the biggest source of known county lines, as home to at least 283 groups, but cities including Birmingham, Manchester also feature and other urban hubs are starting to emerge.
The NCA has designated county lines operation as an area of high-priority vulnerability and is increasing national coordination to help identify groups and protect victims.
Lawrence Gibbons, the NCA’s head of drugs threat and intelligence, said safeguarding was a “vital part of the national response” as more information is gathered.
Duncan Ball, the National Police Chief’s Council lead on county lines, said the latest report demonstrated the extent of the practice.