Substance Misuse Update ru-ok? / Healthy Schools Team 2010

The national picture Evidence continues to suggest that overall drug and alcohol use among young people is declining But - more young people are accessing treatment Almost nine out of ten are receiving help for problems associated with cannabis and/or alcohol Steady decline in reported problems with hard drugs – no. of under-18s treated for problems with heroin / crack has fallen more than a third since National Treatment Agency (NTA) (2009) Substance misuse among young people: The data for

The local picture Illegal drug use has fallen locally but there still appears to be higher levels of drug use amongst young people in the city than those nationally: 15% had ever taken drugs compared with 11% in England 13.7% had either been drunk or taken drugs or solvents at least twice in the past four weeks, or had been drunk and experimented with drugs at least once in their lives ^^ These findings place Brighton and Hove in top quartile of local authorities, 26th highest out of 150 ‘Tellus 3’ survey (2008)

Problematic use? Strong evidence* suggests that some groups are more at risk of becoming problematic users than others: Excluded from school Frequent truants Arrested Homeless Looked after / in care * Offending and Criminal Justice Survey (OCJS), S. Roe & J. Ashe (2008). Interventions to reduce substance misuse among vulnerable young people: guidance, NICE (2007). Young people who have ever been In Brighton and Hove it is estimated that 16% of the population aged years, and 30% of the population aged 17 – 19 years are vulnerable because of these reasons.

Ru-ok? Specialist drug and alcohol treatment service for young people; running since 2004 Specialist drug and alcohol treatment service for young people; running since 2004 Funded by Children and Young People’s Trust and staffed by a team of health, youth and social care professionals Funded by Children and Young People’s Trust and staffed by a team of health, youth and social care professionals Remit to support young people, and their families, with complex substance concerns - where substance use is seriously impacting upon a young person’s day-to-day life Remit to support young people, and their families, with complex substance concerns - where substance use is seriously impacting upon a young person’s day-to-day life Works with any young person under 18 who is resident (or at school) in the Brighton & Hove area, who is experiencing problems with drugs or alcohol and has a desire to reduce or stop their use Works with any young person under 18 who is resident (or at school) in the Brighton & Hove area, who is experiencing problems with drugs or alcohol and has a desire to reduce or stop their use

Ru-ok? statistics

204 young people in treatment young people in treatment

Ru-ok? statistics 204 young people in treatment young people in treatment

Main problem substances

Alcohol

Alcohol Legal drug; often accessed via proxy purchase Legal drug; often accessed via proxy purchase Statistics show a continued decline in the number of young people drinking alcohol, BUT those who do drink are drinking more Statistics show a continued decline in the number of young people drinking alcohol, BUT those who do drink are drinking more Each week, at least 5 young people from Brighton & Hove attend A&E with alcohol related problems Each week, at least 5 young people from Brighton & Hove attend A&E with alcohol related problems

Alcohol - risks NO safe drinking limits for U18s – alcohol can damage development of brain and body NO safe drinking limits for U18s – alcohol can damage development of brain and body Govt. recommend that U15s shouldn’t drink any alcohol Govt. recommend that U15s shouldn’t drink any alcohol Young people more likely to get into a fight, have an accident or have unprotected sex if they’ve been drinking Young people more likely to get into a fight, have an accident or have unprotected sex if they’ve been drinking Alcohol poisoning can cause severe injury or even death Alcohol poisoning can cause severe injury or even death

Cannabis

Cannabis Most widely used illegal drug in UK Most widely used illegal drug in UK Comes in 3 forms – herbal (‘weed’ / ‘grass’, ‘skunk’), resin (‘hash’, ‘solid’), oil (uncommon) Comes in 3 forms – herbal (‘weed’ / ‘grass’, ‘skunk’), resin (‘hash’, ‘solid’), oil (uncommon) Re-classified as Class B drug in Jan Maximum penalties = 5 years (possession) 14 years (supply) Re-classified as Class B drug in Jan Maximum penalties = 5 years (possession) 14 years (supply) But – agreed police response for year olds: reprimand (1 st time), final warning + YOT (2 nd time), arrest (3 rd time) But – agreed police response for year olds: reprimand (1 st time), final warning + YOT (2 nd time), arrest (3 rd time)

Cannabis - risks Regular smokers can become anxious, panicky, suspicious or paranoid Regular smokers can become anxious, panicky, suspicious or paranoid Danger or lung / throat / mouth disease or cancer, especially if smoked with tobacco Danger or lung / throat / mouth disease or cancer, especially if smoked with tobacco No firm evidence it directly causes psychotic illness, (e.g. schizophrenia) BUT evidence that it can hasten pre- existing mental illness or cause relapse, esp. for those with a family history No firm evidence it directly causes psychotic illness, (e.g. schizophrenia) BUT evidence that it can hasten pre- existing mental illness or cause relapse, esp. for those with a family history Regular, heavy use makes it difficult to learn and concentrate and greatly affects motivation Regular, heavy use makes it difficult to learn and concentrate and greatly affects motivation Heavy users can become psychologically dependent Heavy users can become psychologically dependent

‘Meow’ / Mephedrone (4-methylmethcathinone) aka MCAT / Meph / Drone / Bubble

‘Meow’ / Mephedrone Synthetic stimulant which is now illegal to possess in UK Comes in powder (or occasionally capsule) form, which is swallowed or snorted Synthetic stimulant which is now illegal to possess in UK Comes in powder (or occasionally capsule) form, which is swallowed or snorted Users report similar effects to Ecstasy / MDMA, and/or amphetamines/cocaine - i.e. feeling of euphoria, decreased social inhibitions, increased energy and talkativeness Users report similar effects to Ecstasy / MDMA, and/or amphetamines/cocaine - i.e. feeling of euphoria, decreased social inhibitions, increased energy and talkativeness

‘Meow’ - risks Side effects include aggression, anxiety, fits, blackouts, heart and lung problems, paranoia, nosebleeds, burnt/sore nose/mouth Side effects include aggression, anxiety, fits, blackouts, heart and lung problems, paranoia, nosebleeds, burnt/sore nose/mouth Many report bingeing as drug is very addictive Many report bingeing as drug is very addictive Linked to deaths in Sweden and England (death in Brighton not attributed directly to drug but still felt a contributing factor) Linked to deaths in Sweden and England (death in Brighton not attributed directly to drug but still felt a contributing factor) The biggest danger is the drug’s unknown qualities – it has never been medically tested on humans so no-one knows its toxicity or what the long-term physical or mental effects could be The biggest danger is the drug’s unknown qualities – it has never been medically tested on humans so no-one knows its toxicity or what the long-term physical or mental effects could be

Legal Highs Untested, unregulated, synthetic ‘copies’ of other substances Untested, unregulated, synthetic ‘copies’ of other substances Easily available, ivory wave is available on line as ‘bath salts’ Easily available, ivory wave is available on line as ‘bath salts’ ‘Entrepreneurial’ young people are involved in buying in bulk and selling on ‘Entrepreneurial’ young people are involved in buying in bulk and selling on Police have said they will always seize any powder / capsule as a suspected controlled drug and send for testing – if it has been mixed with an illegal drug they may prosecute Police have said they will always seize any powder / capsule as a suspected controlled drug and send for testing – if it has been mixed with an illegal drug they may prosecute Schools urged to ban drug from premises and contact police if pupils found with it on site Schools urged to ban drug from premises and contact police if pupils found with it on site

Ketamine

Ketamine Short-acting but powerful dissociative anaesthetic; used medically during surgery on animals and humans. Currently Class C. Short-acting but powerful dissociative anaesthetic; used medically during surgery on animals and humans. Currently Class C. Comes as liquid or as powder (more common) Comes as liquid or as powder (more common) High doses can cause powerful hallucinations and feeling of detachment from self (‘K-hole’) High doses can cause powerful hallucinations and feeling of detachment from self (‘K-hole’) Users can also experience severely reduced bodily sensation, numbness of limbs and loss of co-ordination Users can also experience severely reduced bodily sensation, numbness of limbs and loss of co-ordination

Ketamine - risks Higher doses can cause unconsciousness, potential respiratory collapse or heart failure Higher doses can cause unconsciousness, potential respiratory collapse or heart failure Side effects include vomiting, convulsions, damage to the urinary tract, bladder and kidneys Side effects include vomiting, convulsions, damage to the urinary tract, bladder and kidneys The main physical dangers are from context of use: anaesthetic qualities leave the taker far more helpless than most ‘recreational’ drugs, therefore highly vulnerable to accident, injury, or assault The main physical dangers are from context of use: anaesthetic qualities leave the taker far more helpless than most ‘recreational’ drugs, therefore highly vulnerable to accident, injury, or assault Regular users can become psychologically dependent Regular users can become psychologically dependent

Class A Ecstasy / MDMA Ecstasy / MDMA LSD / Acid LSD / Acid Heroin Heroin Cocaine & Crack Cocaine & Crack Penalties = Possession: Up to 7 years / unlimited fine Supply: Up to life / unlimited fine Magic mushrooms Magic mushrooms Methylamphetamine (‘crystal meth’) Methylamphetamine (‘crystal meth’) Amphetamines if prepared for injection Amphetamines if prepared for injection

Class B Cannabis Cannabis Synthetic cannabinoids (e.g. ‘Spice’) Synthetic cannabinoids (e.g. ‘Spice’) Amphetamines (Speed) Amphetamines (Speed) Methylphenidate (Ritalin) Methylphenidate (Ritalin) Penalties = Possession: Up to 5 years / unlimited fine Supply: Up to 14 years / unlimited fine

Class C Tranquilisers Tranquilisers Some prescription painkillers Some prescription painkillers Ketamine Ketamine GHB (Gamma hydroxybutyrate) / ‘GBL’ GHB (Gamma hydroxybutyrate) / ‘GBL’ BZP (Benzylpiperazine) and related piperazine compounds Penalties = Possession: Up to 2 years / unlimited fine Supply: Up to 14 years / unlimited fine

2 nd Floor, Ovest House, 58 West Street, Brighton BN1 2RA