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What we know about young people in alcohol and drug treatment

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This week PHE has published two important documents about young people’s substance misuse.

The first is the 2015-16 annual report, which provides data on young people’s use of specialist substance misuse treatment services, which form part of the National Drug Treatment Monitoring System (NDTMS).

The second, a rapid mixed methods evidence review, commissioned by PHE and undertaken by The Children’s Society, is a review of young people’s specialist substance misuse services. This will help commissioners improve these services.

The annual report shows that the numbers of young people seeking treatment for problems with drugs and alcohol (17,000) continues to decline, since a peak in the numbers in 2008-09 (24,000).

While this is encouraging, and is in line with what we know about the declining use of drugs and alcohol among young people, we need to look behind the headline to understand the full picture.

Young people do not develop substance misuse problems in isolation. The 2015-16 data shows that a significant proportion of young people who entered specialist treatment services also had other multiple problems or vulnerabilities that were linked to their substance misuse. These include:

  • having a mental health problem
  • being affected by domestic violence or sexual exploitation
  • not being in education, training or employment

For some young people these wider issues may be the cause of their substance misuse problems, and for others, a consequence. So it is vitally important that young people’s treatment services are working closely with a wide range of other children and young people’s health and social care services, to ensure that vulnerable young people have all their needs supported.

These young people are already at a significant disadvantage in life and, without effective joined up support, there is a very real risk that their lives get derailed and they may continue to use drugs into adulthood.

Young males and females come into treatment services with different vulnerabilities and so require different responses:

  • 6% of young people who seek alcohol and drug treatment report having been sexually exploited, but this is much higher among females (14%) compared to just over 1% of males
  • 17% of young people starting treatment in 2015-16 report having self-harmed, with the proportion of females (33%) significantly higher than males (9%)
  • 25% of females starting treatment reported having mental health problems, compared to 15% of males

Cannabis and alcohol continue to be the main substances for which young people seek help. Since the NDTMS started to collect data on new psychoactive substances (NPS) in 2013-14, we have not seen the increase in numbers of young people coming into treatment for problems with NPS that we might have expected.

Over the past year, 2015-2016, 6% of young people reported having problems with these substances, compared to 5% in 2014-15. Specialist services need to ensure that they are both easily accessible and equipped to work with young people with a range of problem substances, including NPS.

Waiting times for young people’s treatment during 2015-16 continued to be low, which demonstrates the clear recognition that easy access and prompt provision of treatment for young people is vital and a priority for this extremely vulnerable group of young people in England.

The review of specialist services highlights some important principles for local authority commissioners. Essentially:

  • young people and their needs should be at the centre of services
  • quality governance arrangements should be in place
  • multiple vulnerabilities and complex needs should  be properly addressed
  • young people becoming young adults need to be supported as they move into adult services through appropriate transitional arrangements

It is encouraging that the numbers of young people being treated for substance misuse is going down. However it is important to emphasise the complex vulnerabilities experienced by this group and the need to ensure that treatment services are effectively joined up with other young people’s health and social care services.

The review provides important advice and we encourage commissioners of young people’s treatment services to read in conjunction with the 2015-16 annual report.

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