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Specialist help needed for increase in children with substance misuse problems

More places for specialist substance misuse services are needed for the increase in children and young people with substance abuse problems, a report has urged.

Dame Carol Black’s second part of her independent review for government, setting out a way forward on drug treatment and recovery, stated that more funding should be available to improve capacity and quality of specialist substance misuse services in response to increased drug use among children and young people.

“The national Commissioning Quality Standard should ensure that these services are linked with other local services for vulnerable young people,” the report said. “Also, through the national Commissioning Quality Standard, the Department for Health and Social Care should ensure that …. family interventions are more widely available.”

Dame Carol Black’s Part 1 of her review highlighted the extent of the illicit drugs market in the UK, worth almost £10 billion a year, with 3 million users and a supply chain that has become increasingly violent and exploitative.

Part 1 stated that drug deaths are at an all-time high and drug addiction fuels many costly social problems, including homelessness and rising demands on children’s social care. The drugs market is driving most of the nation’s crime and people with serious drug addiction occupy one in three prison places.

This Part 2 revealed highlighted The Smoking, Drinking and Drug Use among Young People in England survey which shows that drug use among children and young people aged 11 to 15-years-old has increased by over 40% since 2014, reversing a previous long-term downward trend.

The report reveals that the rise is evident across a wide range of substances and most socio-economic groups. The most alarming development is the widespread involvement of vulnerable children and young people in drug supply, often through ‘county lines’ where young people are targeted to distribute drugs from cities to rural areas.

Some groups of children are exposed to additional risk around drug taking or selling, including children who are outside mainstream education. Each local authority should have a fair access protocol, agreed with the majority of the mainstream state-funded schools in its area, to maximise the protection that education gives to vulnerable children. This will help ensure that children who don’t have a school place, especially the most vulnerable, are offered a place at a suitable school as quickly as possible. All admission authorities, including those of academy and free schools, should be required to participate in the fair access protocol for their area.

The review highlights how addressing children’s mental health issues early is also a protective factor, and the government is committed to putting in place additional support at school level, including new mental health support teams for all schools and colleges and providing training for senior mental health leads.

The government set out its ambition to make the UK the safest place in the world to be online in its response to the online harms white paper consultation. However, drug dealers have a significant online presence, using social media to push drugs to children and young people. Decisive action is needed to curtail online harm and introduce legislation which places greater responsibility on technology companies to address these issues.

Families with parental drug misuse need specific support which must be co-ordinated at a local level. Outcomes of programmes such as the Children of Alcohol Dependent Parents (CADeP) programme provide promising emerging evidence and this support should be expanded to drug misuse and, depending on results, rolled out across England.

The fact that targeted early identification of young people at risk, and that brief and early intervention need to be strengthened is made explicit, given that young people with treatment requirements coming into services have increasingly complex needs, often involving poor mental health and self-harm, and sometimes criminal or sexual exploitation.

“Services need to be trauma-informed and treatment should be family-based if necessary, particularly for young people whose parents are themselves dependent on drugs or alcohol,” said the report.

Like adults, young people with drug-use problems need a broad treatment package, with a combination of specialist treatment and wider health and social care services. The challenges they face include their family circumstances and mental health difficulties. Commissioning structures at national and local level must ensure that these different services work together.

The report recommends that the Office for Health Promotion should undertake more work on defining and promoting effective drug and alcohol services and practice for young people. It should also ensure that there is better prevalence data to support planning for local areas.

The Department for Education should encourage schools to seize the major prevention opportunity presented by the statutory guidance for Relationships, Sex and Health Education (RSHE). This guidance came into force in England from September 2020 and sets out requirements in relation to teaching about tobacco, alcohol, prescription drugs and illicit drugs.

It is equally important that children attend school and have rewarding, fulfilling activities available to them outside of school. They also need adequate support services, particularly for mental health.

We recommend that the DfE and Department for Digital, Culture, Media and Sport (DCMS) lead investment in age-appropriate evidence-based services and support all young people to build resilience and avoid substance misuse. Local authorities should identify, and provide additional support to, those young people most at risk of being drawn into using illicit substances or involvement in supply,” said the report.

As Professor Dame Carol Black published the second part of her Independent Review of Drugs, which sets out more than 30 recommendations to government to help overcome the harm drugs have caused to individuals, families and communities across the country, the government announced that a new drugs unit will be set up to help end illegal drug-related illness and deaths, the government has announced today.

The Joint Combating Drugs Unit will bring together multiple government departments – including the Department of Health and Social Care, Home Office, Ministry of Housing, Communities and Local Government, Department for Work and Pensions, Department for Education and Ministry of Justice to help tackle drugs misuse across society.

This joint approach recognises that treatment alone is not enough and wider support, including with housing and employment, is essential to aid recovery.

Professor Dame Carol Black said: “Drug deaths are at an all-time high and drug addiction fuels many costly social problems, including homelessness and rising demands on children’s social care.

“The government faces an unavoidable choice: invest in tackling the problem or keep paying for the consequences. A whole-system approach is needed and this part of my review offers concrete proposals, deliverable within this parliament, to achieve this,” she added.

Rosanna O’ Connor, Director of Drugs, Alcohol, Tobacco and Justice at Public Health England said: “Drug treatment services save lives and help many people recover from drug dependence, improving not only their lives but those of their families, their communities and wider society. We know treatment works and so it’s essential that everyone can easily get the treatment they need.

“We welcome Dame Carol Black’s recommendation for increased funding that is protected and prioritised for treatment and recovery services to ensure that everyone can get the support they need to move forward with their lives,” she concluded.

Review of drugs part two: prevention, treatment, and recovery

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