Substance abuse

Patterns of young people’s drug and alcohol use often change, so services need to be flexible and respond effectively to changing needs. While cannabis and alcohol are the most common substances that young people said they have a problem with, a very small minority will present with class A drug problems (such as heroin and cocaine). Organisations working with young people should be prepared to deal with all substances, including tobacco and increasingly new psychoactive substances (NPS).

Prevalence data for trends in alcohol, drug and tobacco use among young people from the ‘Smoking, drinking and drug use among young people in England’ survey shows a whole population decrease in the prevalence of drug, alcohol and tobacco use among school pupils aged 11 to 15. The survey also finds that young people who truant or have been excluded from school are much more likely to have experimented with substances including tobacco.

Our information shows that during the first 9 months of 2015/16, 39 young people had accessed treatment. Most young people who accessed services used cannabis. As Wokingham’s figures are very low, small changes can have a disproportionate impact on percentages so these have not been used in this section of the JSNA.

Numbers in treatment have significantly improved recently and the Drug And Alcohol Team continues to work in close partnership with the Youth Offending Service and Targeted Youth Service to ensure that its service continues to better meet the needs of young people in Wokingham.

Legal highs are emerging as a trend, although not to the same extent as experienced in some neighbouring boroughs. 

National guidance

The Home Office’s Drug Strategy: Reducing demand, restricting supply, building recovery: supporting people to live a drug-free life (2010) still underpins current practice.

Read the young people's drug, alcohol and tobacco use needs assessment support pack on the public Health England website. This guidance highlights national guidance for working with young people who misuse substances.

Key drivers include

• Effective evidence-based interventions are being commissioned universally and in a targeted way to prevent young people’s use of drugs, alcohol and tobacco

• Evidence suggests that a number of risk factors (or vulnerabilities) increase the likelihood of young people using drugs, alcohol or tobacco

• Prevention approaches for young people are usually not drug, alcohol or tobacco specific but are focused more on reducing risks and increasing resilience. The more risk factors young people have, the more likely they are to misuse substances. Risk factors include experiencing abuse and neglect, truanting from school, offending, early sexual activity, antisocial behaviour and being exposed to parental substance misuse

• The strongest single predictor of the severity of young people’s substance misuse problems is the age at which they start using substances

Specialist services

A full range of specialist drug alcohol and tobacco interventions are available to young people in need, as follows

• Specialist substance misuse interventions are individual packages of care-planned support, which can include medical, psychosocial or specialist harm-reduction interventions that build young people’s resilience and reduce the harm caused by substance misuse

• Specialist substance misuse services help young people to stop using drugs and alcohol, to reduce the harm they cause themselves and others, to develop their resilience, and to manage the risks they face, ensuring that when they leave services they can sustain their progress. This might include giving support to parents and carers to help the young people with healthy decision making

• Girls face a number of specific issues, including increased risk of alcohol problems. A recent report highlights that responses to adversity, including abuse, tend to be differentiated by gender, with boys more likely to externalise problems (and to act out anger and distress through antisocial behaviour) and girls to internalise their responses in the form of depression and self-harming. Substance misuse services for young people may therefore need to consider these gender issues

• Young people’s substance misuse services also need to have the knowledge to understand, identify and respond to child sexual exploitation and abuse, because of the links to the use of alcohol and drugs

• Commissioning is integrated across prevention and specialist interventions and the wider children’s agenda

Interventions and multi agency working

If commissioning is effectively integrated, services will work together effectively to help build resilience in young people and help them make informed choices not to misuse substances. A skilled workforce is in place to provide effective interventions. The Department for Education’s common core skills describes the skills and knowledge that everyone who works with children and young people is expected to have. The 6 areas offer a single framework to support multi-agency and integrated working, professional standards, training and qualifications across the children and young people’s workforce.

These are

• Effective communication and engagement with children, young people and families

• Child and young person development

• Safeguarding and promoting the welfare of the child or young person

• Supporting transitions

• Multi-agency and integrated working

• Information sharing

The therapeutic relationship young people have with their keyworkers is vital. Positive outcomes depend on a positive and trusting relationship between them. Research suggests that young people’s feelings about the quality of their relationships with key adults and peer mentors contribute significantly to their wellbeing and positive outcomes.

National data on drugs

A survey into smoking, drinking and drug use was carried out annually on a sample of Year 7 to 11 pupils to provide national estimates on smoking, drinking, and drug use amongst young people aged 11 to 15 until 2015. No survey is planned for 2016.

The most recent report, published in July 2015, can be found on the Health and Social Care Information Centre website.

• In 2014, 15 percent of pupils had ever taken drugs, 10 percent had taken drugs in the last year, and 6 percent had taken drugs in the last month

• The previous decline seen in drug use between 2001 and 2010 had slowed in 2014

• 59 percent of pupils could recall receiving lessons on drugs in the past year

Source: Health and Social Care Information Centre.

The table below applies the percentages found in the national survey to the local school population in Wokingham (January 2015) to give a crude estimate of local numbers.

National and local authority data on young people accessing services can be seen on the National Drug Treatment Monitoring System on the Public Health website. 

Their December 2015 report for Wokingham shows:

So, although many young people have probably taken drugs locally, few have been referred for drug misuse services. (* in the above table denotes between 1 and 5 young people.)

Other substance misuse

The national school survey also found that:

•  In 2014, less than 1 in 5 11 to 15 year olds (18 percent) said that they had smoked at least once. This was the lowest level recorded since the survey began in 1982, and continues the decline since 2003, when 42 per cent of pupils had tried smoking

• Over a fifth (22 percent) of pupils had used e-cigarettes at least once. This included most pupils who smoked cigarettes regularly (89 percent)

• E-cigarette use was considerably lower among pupils who had never smoked (11 percent)

• 1 in 10 (10 percent) of pupils had used water pipe tobacco at least once

• In 2014, 38 percent of 11 to 15 year olds had tried alcohol at least once, the lowest proportion since the survey began

• 6 percent of pupils said that they sometimes or always drank energy drinks at the same time as they drank alcohol

• The prevalence of drug use among 11 to 15 year olds in England declined between 2001 and 2010. Since then the decline has slowed. In 2014, 15 percent of pupils had ever taken drugs, 10 percent had taken drugs in the last year, and 6 percent had taken drugs in the last month

• The estimates from this survey indicate that in England in 2014 around 90,000 pupils aged between 11 and 15 were regular smokers, around 240,000 had drunk alcohol in the past week, 180,000 had taken drugs in the last month, and 310,000 had taken drugs in the last year

Referrals from Children and Family services are low in comparison to national figures. This may be due to proactive referrals from other agencies, but it is probably linked to the low numbers of children referred to children’s services locally. Further exploration and communication work with relevant teams is being developed to establish local links and needs.

In addition, there is little input for year 6 students (age 10 to 11) from the Young People’s Service, however, this is recognised as a key transition age.

Being a small authority, Wokingham has few workers specialising on substance misuse. This has impacted our ability to promote the service actively to partners and undertake prevention work. The Drug And Alcohol Team (DAAT) and the Youth Offending Team are looking into how the service can be expanded to enable early intervention work and targeted programmes within universal services.

Recommendations

Recommendations for consideration by other key organisations such as: CCG’s, General Practices, Local Authority department e.g. housing and other providers are

• Work in partnership to raise awareness of services available, as well as sharing intelligence to identify gaps

  • Build resilience within current service provision

  • Offer targeted services and programmes for young people who are not necessarily needing help but are identified as being at risk