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Suzanne Hare and Dee Stanford work at Cambridgeshire and Peterborough NHS Foundation Trust. This presentation for the ADEPIS seminar on NPS - held on Monday 19th May - is intended to explore local treatment procedures for NPS users.

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  1. 1. CASUS Cambridgeshire Child and Adolescent Substance Use Service Suzanne Hare & Dee Stanford
  2. 2. CASUS delivers: • Information, advice to young people • Advice and support to parents / carers or someone affected by another person’s drug or alcohol use. • Training, support and consultancy to professionals working with young people. • Support for PSHE in schools and alternative education settings. • Sessions for groups of young people at risk and in vulnerable situations. • Specialist treatment drug and alcohol treatment for young people, which include psychosocial interventions, family work, harm reduction and specialist prescribing.
  3. 3. Referral Process • A parent/ carer or professional can refer • Self referrals • The young person must consent to referral for treatment. • Phone call 01480 415 278 • CASUS Referral form / letter or CAF ( not via SPA at present) • Confidential advice and information for parents and carers is available from CASUS . •
  4. 4. What is happening in Cambridgeshire? Health Related Behaviour Survey Professor Balding, Exeter University 2002- 2012 Little or no mention of NPS What will 2014 show??
  5. 5. Good News 2011-2012 NTA data tells us… 1) The number of under 18s accessing specialist services for substance misuse in England fell to 20,688 (figure peaked at 24,053 in 2008/2009) 2) The number of young people being treated primarily for class A drugs (such as heroin and cocaine) has fallen by two thirds from 5 years ago 3) Alcohol and Cannabis remain by far the main substances for which under 18s access specialist services in England (92%) 4) NPS. Very small numbers but data capture methods poor.
  6. 6. SUD No - SUD 10yrs 20 yrs Experimentation and SUD
  7. 7. Not so good news • The rise of Poly-pharmacy (“living in the sweet shop...”) – a chemical universe- new substances abound. - The National Poisons Information Service 2012/13 report notes a 49% increase in telephone enquiries and 128% increase in TOXBASE accesses relating to nps • Early (< 16 yrs) exposure to (particularly with early positive self-evaluations) drugs such as cannabis -> associated with poorer prognosis, such as adult dependency (Fergusson et al 2003). • Those young people who do use substances are starting younger, using more, and using stronger varieties
  8. 8. Novel Psychoactive Substances Legal status: legal, Temporary Class, ABC Cost: various Effects: stimulant, depressant, hallucinogen Risk: poisoning, there is no historic data on effects, they are very difficult to treat in A&E, symptomatic relief in only, long term effect are mostly unknown
  9. 9. NPS Treatment • A&E and GPs treat the majority of acute harms arising from NPS • Routine management of intoxication and poisoning evidence of treatment adaption for NPS - “mimic illicit drugs but stronger and potentiated by alcohol etc” • Challenging to provide information and guidance for those seeking healthcare but wish to continue to use NPS. “a new substance every 6 days “ “ mxe OTS” AAPG Drug Strategy
  10. 10. Early Findings from UK’s First National Online Survey of Users of New Psychoactive Substances (Legal Highs) • “legal and therefore safe” - main driver for use – “illusion of safety” • belief that health consequences are mild and will not require treatment. • “have I broken the law?”
  11. 11. CASUS Treatment Model
  12. 12. NPS CASUS Treatment • Primary drug for Rx remains cannabis and alcohol • NPS identified in taking of Drug Hx • Immediate harm reduction messages - Overdose, poisoning, - Hep B - Drug interaction • Psycho-education • Explicit with ‘our concerns’ (heroin, solvents, NPS) • MI to address higher ambivalence • Treatment as usual, including co morbidity
  13. 13. Web: Youtube: CASUStv Twitter: casus_cpft Email: Phone: 01480 415278
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