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Young people: alcohol and other drugs, treatment and support in England

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Young people: alcohol and other drugs, treatment and support in England

  1. 1. Young people: drugs, treatment and support Andrew Brown Director of Policy, Influence and Engagement, DrugScope
  2. 2. Context • Most young people will not use substances, and where they do the majority will do so rarely and are unlikely to come to significant harm. • The last decade has seen significant falls in the number of young people using substances. • However a small proportion of under 18s continue to require specialist services and research for DfE suggests that the annual cost of crime and health of young people’s substance use is £104 million a year.1 • The same research estimated a benefit of £4.66-£8.38 for every £1 spent on young people’s drug and alcohol treatment. • Young peoples substance services are commissioned as part of local authorities public health responsibilities. 1 Specialist drug and alcohol services for young people: a cost benefit analysis, DfE (2010)
  3. 3. Policy Context • The 2010 drug strategy saw the Department for Education leading on reducing demand for illicit drugs. • However, following a review of its purpose the DfE has relinquished most of its role in drug policy, as a consequence the only remaining responsibility it has is in setting the school curriculum – which is supported by the ADEPIS project http://mentor-adepis.org/. • The Home Office and Department of Health now have shared responsibility for the reducing demand sections of the strategy, with Public Health England taking a lead in liaising with local commissioners and in running the FRANK website and helpline. • There is a commitment from government to develop the public health outcomes framework to include outcome indicators based on prevalence data for 15 year olds – to be collected through the What about Youth? survey.
  4. 4. Lessons from Young people’s drug and alcohol treatment at the crossroads (DrugScope 2010) • Working with young people in treatment is not only about problem drug or alcohol use, but multiple needs. • A lot of the work done by specialist drug and alcohol services is not ‘treatment’ in the narrow medical sense. • Polydrug use creates a new challenge for services. • Young people’s services should not be judged by the same targets as adult services. • A key challenge is the gap between young people’s and adult services and the issues of transition this raises. • Young people with drug problems may be involved in drug supply and services need to address this relationship. • We need investment in community and social regeneration as well as one-to-one support.
  5. 5. Key points from Domino Effects: The impact of localism and austerity on services for young people and on drug problems (UKDPC 2012) • Young people’s services are particularly vulnerable to cuts. • Cuts to generic services can have a knock-on effect on substance misuse problems, which may be being overlooked. • There is increasing variation in provision between areas, if good practice is to be spread and developing problems addressed some co-ordinated monitoring needs to be established.
  6. 6. Proportion of young people who took drugs in the last year 35.0 30.0 25.0 20.0 15.0 10.0 5.0 0.0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 16-24 years 11 - 15 years Based on the SDD and CSEW surveys approximately 1.5 million young people and young adults took drugs last year
  7. 7. Estimate of direct government spend on tackling drug use in 2011/12 1600 1400 1200 1000 800 600 400 200 0 Enforcement Treatment Early interventions Non-rehabilitative treatment activity Education and information campaigns £ (millions) “The overall EIG budget is £2.2bn for 2011/12 and drug-specific spend has been estimated as £220m; 10 per cent of the total.” Source: Drug Strategy 2010 Evaluation Framework – evaluating costs and benefits, Home Office (2013)
  8. 8. How substance misuse spending by local authorities broke down in 2013-14 700 600 500 400 300 200 100 0 Substance misuse - Drug misuse - adults Substance misuse - Alcohol misuse - adults Substance misuse - (drugs and alcohol) - youth services Smoking and tobacco - Stop smoking services and interventions Smoking and tobacco - Wider tobacco control £ (millions) Source: Local authority revenue expenditure and financing England: 2013 to 2014 individual local authority data
  9. 9. Young people in specialist drug and alcohol services 30,000 25,000 20,000 15,000 10,000 5,000 - 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13
  10. 10. Which substances are identified as problems for young people in specialist services 80% 70% 60% 50% 40% 30% 20% 10% 0% Primary Adjunctive
  11. 11. Young People presenting to specialist services with cannabis and alcohol issues 16,000 14,000 12,000 10,000 8,000 6,000 4,000 2,000 - 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 Cannabis Alcohol
  12. 12. Young people presenting to specialist services with issues to do with club drugs 2500 2000 1500 1000 500 0 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 Ketamine Ecstasy Mephedrone
  13. 13. Source of referrals to specialist services 40 35 30 25 20 15 10 5 0 %
  14. 14. Guidance: Interventions to reduce substance misuse among vulnerable young people • Develop a local strategy • Use existing tools to identify children and young people who are misusing, or at risk of misusing, substances. • Work with parents and carers and other organisations involved with children and young people to provide support and, where necessary, to refer them to other services. • Offer motivational interviews to those who are misusing substances. • Offer group-based behavioural therapy to children aged 10– 12 years who are persistently aggressive or disruptive – and deemed at high risk of misusing substances. Offer their parents or carers group-based parent skills training. • Offer a family-based programme of structured support to children aged 11–16 years who are disadvantaged and deemed at high risk of substance misuse.
  15. 15. Issues and challenges • Evidence base for effective prevention interventions is slim and few trials conducted in the UK. • Services balancing prevention and early intervention – as well as wider the risky behaviours agenda. • National policy leadership more difficult without DfE buy-in. • Hollowing out of commissioning expertise at local level.
  16. 16. Thank you Andrew Brown Director of Policy, Influence and Engagement DrugScope @andrewbrown365 andrewb@drugscope.org.uk www.drugscope.org.uk

Editor's Notes

  • Early Interventions = The Family Nurse Partnership; Sure Start Programme; Intensive Family Pathfinders; Family Intervention Programmes; Myplace; Personal, Social, Health and Economic (PSHE) education; Positive
    Futures; Choices

    Non-rehabilitative treatment = Work Programme; tailored conditionality; employment provision; employment engagement; Recovery Champions; homelessness prevention; Supporting People.

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