Substance misuse

Substance misuse is often a symptom of vulnerability among young people, who may already have difficult issues in their lives that are made worse by drugs and alcohol.

The Government’s 2010 drug strategy promotes the need for good quality education and advice to young people and their parents and for targeted support to prevent drug or alcohol misuse and early interventions when such problems first arise.

What do we know?

A number of risk factors increase the likelihood of young people using drugs or alcohol. These include abuse and neglect, truancy, crime, early sexual activity, anti-social behaviour and parental substance misuse. (Source: Drug Strategy 2010).

The more risk factors a young person has the more likely they are to misuse substances and to suffer the harm this causes as they develop into adulthood. However, protective factors that build young people’s resilience, such as educational achievement, positive relationships and good physical and mental wellbeing, can contribute to good outcomes, despite negative life experiences.

Young people who misuse drugs and/or alcohol are at higher risk of achieving poor outcomes in terms of education, training and employment. There is also an increased risk of family breakdown and accommodation issues. Young people may also turn to crime in order to fund their drinking or drug use.

Facts, Figures, Trends

Among those young people receiving treatment in Slough in 2014/15 the main substances are cannabis and alcohol. None of the young people in treatment were currently or previously injecting drug users, or have ever injected drugs.

The majority of young clients in Slough were self-referred or referred by family and friends (this has increased from 11% to 24% since last year). We have a lower number of referrals from children and family services in comparison to last year (down from 17% to 6%).

Approximately 50% of the young people in treatment are 16 years old with 81% of them in education (this is higher than the figure nationally of 71%). The majority of them are white British (65%) and the majority are male (65%).81% of the clients reported various mental health issues, including attempted suicide, depression, mental Illness and self-harm, so this should continue to be an area of focus for the services.
(Source:service data provided by Turning Point).

National & Local Strategies (current best practices)

National

The National Drug Strategy 2010 (revised 2012) set out Governments commitment to reduce demand, restrict the supply of drugs, build recovery and support people to live drug free lives.

The National Institute for Health and Clinical Excellence (NICE) have published a number of documents relating to young people and substance misuse . NICE Guidance PH4: Interventions to reduce substance misuse among vulnerable young people is the most relevant to ensure that local referral pathways are in place.

Public Health England’s (2015) Joint Strategic Needs Assessment (JSNA) support pack for alcohol and drugs identifies different levels at which a range of different preventive and treatment services need to operate. Excerpts from this include:

"Evidence suggests that specialist substance misuse interventions contribute to improved health and wellbeing, better educational attendance and achievement, reductions in the numbers of young people not in education, employment or training and reduced risk taking behaviour, such as offending, smoking and unprotected sex. A significant proportion of the young people known to youth justice disclose concerns relating to substance use and misuse."

Local

Locally a three year substance misuse strategy is in place which sets out the councils intentions with regards to the commissioning of substance misuse services taking into account identified needs.

The Slough young people’s substance misuse service has the following objectives:

  • decrease the consumption of substances used by individual young people taken onto the caseload
  • increase the numbers engaging in effective services
  • increase the number of days attended at School, College or Employment by individual young people taken onto the caseload
  • decrease offending by individual Young People not subject to Youth Offending Team (YOT) supervision
  • improve the health and wellbeing of individual young people taken on to the caseload

The Drug and Alcohol Action Team (DAAT) also support and commission an intensive service for families affected by substance misuse. The Family Intensive Engagement Service (FIES) is part of the main treatment services and they work within the agendas set out by the Troubled Families agenda. They engage with families who have substance misuse issues to motivate them and provide opportunities for change. They aim to provide intensive, structured and practical support, tailored to the needs of individual families, to enable families to live safely and achieve positive and stable outcomes (including work with the young people).

What is this telling us?

A wide range of Universal and Targeted services have an important role to play in helping young people to strengthen their resilience by developing the factors known to be protective, such as educational achievement, training and employment, good physical and mental health and wellbeing and positive relationships.

These services need to routinely screen and assess young people and refer them to the specialist substance misuse service if they have emerging drug or alcohol problems, as well as providing evidence-based information and interventions at the earliest opportunity.

Staff working in universal and targeted services also need to be able to accurately assess and support young people affected by parental substance misuse.

Public Health England (2013) recommends that specialist substance misuse services must take account of issues such as access and engagement, assessment and care planning, joint working, delivery of high quality evidence-based interventions, psychosocial and pharmacological interventions, harm reduction, high intensity support for the most vulnerable young people, transition to other services and support for care leavers.

What are the key inequalities?

As discussed above, substance misuse is often a symptom of vulnerability in young people and is an important source of health inequality. Reducing the substance misuse in young people is important in reducing inequalities.

What are the unmet needs/service gaps?

The DAAT continue to focus on some areas of service provision:

  • the service focuses mainly on tier 3 interventions for those young people using substances, however, focus on lower level, tier 2 interventions should continue to try and prevent problems escalating.
  • the CAMHS service currently provides mental health services to those under 18 years old. CAMHS need to work more closely with our substance misuse services to ensure that all referrals are dealt with appropriately.
  • a reduction in referrals from children and family services may require further investigation internally to identify if the referral pathways are clear to ensure appropriate referrals are made.
  • housing services should continue their commissioning of specific support services for young people who have become or are in danger of becoming homeless due to their misuse of substances.

Recommendations for consideration by other key organisations

Continue collaborative working between children’s services, education, mental health services, and specialist substance misuse services.

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