Presentation on current position for targeted and specialist services in relation to young people's substance use in England.

1. Young people: drugs, treatment
and support
Andrew Brown
Director of Policy, Influence and
Engagement, DrugScope

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. 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. 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. 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. 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. 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. 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. 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. Which substances are identified as problems
for young people in specialist services
80%
70%
60%
50%
40%
30%
20%
10%
0%
Primary Adjunctive

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. 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. Source of referrals to specialist
services
40
35
30
25
20
15
10
5
0
%

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. 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. Thank you
Andrew Brown
Director of Policy, Influence and
Engagement
DrugScope
@andrewbrown365
andrewb@drugscope.org.uk
www.drugscope.org.uk