Issues for young people with problematic substance use

What are the issues? (CCQ 2012)

• Young people experiment with drugs and alcohol.

• Whether this is ‘misuse’ depends on why and how they are using it and how old they are.

– For instance, ‘experimenting’ at 17 is different to ‘experimenting’ at 10.

– Also, smoking cannabis at a party is different to smoking cannabis all day, everyday.

• ‘Misuse’ is where it is either harmful to the young person and/or signifies a form of self medication or self harm.

What are the issues (cont.)?Substance misuse among young people presents the same harms as among adults, but with some additional risks associated with their age and level of development.

• Young people can be physically more at risk of poisoning and the effects of substances.

• Young people can be more exposed to risky use of substances than adults.

• Young people are more at risk of exploitation by others.

• Some young people have double vulnerabilities due to their age and other factors (e.g. a learning difficulty, care leavers, young offenders).

What are the issues?(Crome et al 2004)

Where drugs are used problematically, there are almost always other problems, such as depression, family break up, school exclusion.

• Risky behaviour– Young people lack experience and therefore may put themselves in more

danger when using substances.

– They do not understand how to use less harmfully, may use in risky settings and take more risks when intoxicated.

– For instance, stimulant-related deaths by drowning among young people at surfing resorts in the summer are a feature of UK mortality data (Webb et al,

2003).

What are the issues?(Crome et al 2004)

Mortality and morbidity

• Acute alcohol poisoning is the most common substance-related cause of death among young people – this is excluding alcohol-related accidents on the roads.

• Young people are more at risk of physical harms such as HIV, Hep B & C or overdose, because of their lack of experience, resources and knowledge.

For instance:• An inexperienced young person is more likely to share a needle and not

have access to a needle exchange service or provision (often available at chemists or drop in centres).

• An inexperienced young person is more likely to be persuaded to drive a car while intoxicated on cannabis, or get in a car with an intoxicated driver.

What are the issues?(CCQ. 2012)

Mental health

– Problem drug and alcohol use among young people is more likely to be a symptom of other problems which make them vulnerable.

– It also compounds those problems and leads to further distress; depression, offending, truancy and school exclusion, anti-social behaviour.

– Young people should be assessed for mental illness, social disadvantage and vulnerability as well as their substance use.

Vulnerable young people (NICE 2007)

Vulnerable young people - < 26 years

• Certain young people can be considered more vulnerable than others and require specific screening, assessment, and co-ordinated support. For example:

– those whose family members misuse substances.– those with behavioural, mental health or social problems.– those excluded from school and truants.– young offenders.– children in the care of the State, i.e. ‘looked after’ children.– those who are homeless.– those exploited through prostitution.– those from some black and minority ethnic groups..

We could add asylum and refugee young people, especially where unaccompanied.

References• CCQ (2012) Practice standards for young people with substance misuse problems.

CCQ. Available at: http://www.rcpsych.ac.uk/pdf/Practice%20standards%20for%20young%20people%20with%20substance%20misuse%20problems.pdf

• Crome I Ghodse H Gilvarry E & McArdle P (2004) Young People and Substance Misuse. London, Gaskell.

• NICE (2007) Interventions to reduce substance misuse among vulnerable young people. National Institute of Clinical Excellence Public Health Guidance 4.

• Webb L Oyefeso A Schifano F Cheeta S Pollard M & Ghodse H (2003) Cause and manner of drug related fatality. Drug and Alcohol Dependence 72, 67-74.