The Office for National Statistics recently published their annual report on young people (aged under 18 years) in drug and alcohol treatment This release covers the 2017/18 financial year and highlights the concerns felt within the YP treatment sector for some time.
Less accessing treatment? Does this reflect the need?
During the 2017/18 period there were 15,583 young people in specialist substance misuse services. This deomonstrates a 5% decrease from 2016-17 (16,436) and a continuation of a year on year downward trend. There has been a 35% decrease since a peak in 2008-09 when 24,053 young people received treatment.
A number of contributors which have potentially influenced this downward trajectory include the possibility that it reflected the declining prevalence that has been the celebrated and accepted narrative for a number of years.
The point of contention that challenges this often accepted line, is that there is emerging evidence that the number of young people using drugs is increasing. For the first time the ONS accept this within the document by including the important line “the more recent decreases in young people accessing treatment services may not reflect the actual need”.
Nearly a fifth (18%) of pupils said that they had taken drugs in the last year according to the latest NHS Digital survey of school age children conducted in 2016. With the exception of nitrous oxide (newly added to the drug prevalence measure in 2016) and NPS, 15% of young people said they had taken drugs in the last year, this was an increase from 10% in 2014.
Another source also showed an increase in any class A drug use in the last year among 16-24 year olds, going from 6.8% in 2007-08 to 8.4% in 2017-18. This data was collected by the self reported Crime Survey for England and Wales 2017-18.
Finally, the Department for Education data for 2016-173 demonstrates that school exclusions where alcohol and drug use is a factor has increased greatly within recent years. Fixed term exclusions have increased 34% since 2012-13 while permanent exclusions have increased by 95% since 2010-11.
Unsurprisingly, Cannabis remained the most common drug by far that young people came to treatment for with the majority (88%) of young people in specialist services reporting that they had an issue with this drug. Although total numbers have decreased slightly in recent years, the proportion of young people in treatment who have cannabis problems has remained stable in the last 2 years at 77%.
The next most commonly reported problematic substance was alcohol. There were 7,206 young people in treatment for alcohol problems (46%). The number of young people receiving help for alcohol problems continues to steadily decline from the peak in 2008-09 when 16,047 were treated for alcohol.
The number of young people entering treatment for problems with ecstasy in 2017-18 increased by 16% from the previous year (1,815 to 2,112) and has almost doubled since 2013-14. The increase in ecstasy treatment numbers was seen across all age groups.
There was also an 18% increase in young people in treatment for crack problems over the same period, although the numbers were much lower (83 in 2016-17 and 98 in 2017-18).
Benzodiazepine treatment is reported for the first time in this report. Young people who had problems with benzodiazepines at the start of treatment almost doubled from the previous year (161 in 2016-17 and 315 in 2017-18). Alprazolam (most commonly called Xanax) was the benzodiazepine which saw the biggest increase, (8 in 2016-17 to 53 in 2017-18).
Young people entering treatment for problems with new psychoactive substances (NPS) more than halved since the previous year (585 in 2016-17 and 270 in 2017-18) and is 74% lower than 2015-16 when 1,056 reported problematic use. Similar falls were seen in adults starting treatment over the same period, particularly in those under 25. This fall coincides with NPS being made illegal.
Which young people seek help?
Age & gender
Two-thirds of the young people accessing specialist substance misuse services were male (66%). Around three-quarters (74%) were aged 15 or over. The median age for both female and male was 15 years old. Only 43% of females were aged 16 or over compared to nearly half (49%) of males.
While the number of younger children (under 14) in treatment remains relatively low, it has increased from last year (1,342 in 2016-17 to 1,422 in 2017-18).
Any substance misuse among young people – particularly the younger age groups – is concerning because they are likely to be at risk of other harms as well as their alcohol or drug use. Safeguarding needs to be a priority and the other risks and harms need to be addressed.
The majority of young people (76%) in treatment services were white British. This is similar to the general population, where 78% of young people aged 10 to 17 were white British according to the 2011 census. For the remaining clients, 4% were other white and 3% were white and black Caribbean or Caribbean. No more than 2% reported any other ethnic group.
Education services was the most common route into specialist treatment services, with 5,178 (31%) young people being referred from these. Mainstream education was the single largest source of referral, accounting for over a quarter of all referrals (26%, or 4,432). The proportion referred by education services has increased over recent years (24% in 2012-13), while referrals from the youth justice system continue to decline (34% in 2012-13 to 22% in 2017-18).
The majority of young people in specialist substance misuse services have other problems or vulnerabilities related to their substance use, the table below shows the range of vulnerabilities identified among young people starting treatment last year.
It is dispiriting to cover yet another report in the social care sphere where the most obvious conclusion is that the public spending cuts associated with austerity have resulted in vulnerable people no longer able to access the services they need. How else can we explain an increase in the number of young people using drugs alongside a decrease in the number seeking help?
There is a double danger here in that with young people unable to receive prompt help for their drug and alcohol problems, the extent of need is under-estimated, potentially making further cuts and reductions in treatment capacity possible in future years.