Young people, substance misuse and PHE Jez Stannard, Senior programme manager (alcohol, drugs and tobacco division)

summary Explain what we know about prevalence of use Summarise the advice PHE gives to LAs around the YP substance misuse prevention and treatment agenda Set the scene around specialist substance misuse services (treatment) and the data from the latest annual report – including some London specific data Presentation title - edit in Header and Footer

Prevalence Smoking, Drinking and Drug Use survey (now biennial) shows a continued national decrease in prevalence amongst 11-15 year olds ….But it has its limitations What about the What About YOUth survey? Unfortunately this does mean that we don’t have reliable, comprehensive local level prevalence data Presentation title - edit in Header and Footer

SDD survey – key data - Around 240,000 pupils aged between 11 and 15 had drunk alcohol in the past week, 180,000 had taken drugs in the last month, and 310,000 had taken drugs in the last year 38% had tried alcohol at least once (lowest proportion since the survey began recording alcohol use in 1988) Drug use declined between 2001 and 2010 and since 2010 the decline has slowed. In 2014 15% had ever taken drugs, 10% had taken drugs in the last year, and 6% had taken drugs in the last month. This is the lowest proportion since the survey started recording drug use in 1998 - Pupils were more likely to have taken cannabis than any other drug. 2.5% of pupils said that they had ever taken NPS - Pupils who had truanted or been excluded from school were more likely than other pupils to say that they took drugs once a month or more or that they had taken Class A drugs in the last year Presentation title - edit in Header and Footer

We mainly provide advice to LAs through the PHE JSNA commissioning prompts Presentation title - edit in Header and Footer

Main advice PHE gives to LA commissioners is via the annual JSNA commissioning prompts: http://www.nta.nhs.uk/healthcare-JSNA.aspx Covers: Universal and targeted evidence base prevention Specialist treatment On universal: “Approaches that focus on reducing risk and increasing resilience are more effective than those that focus on topic specific programmes and interventions” We commission Mentor-ADEPIS for schools and prevention practitioners http://mentor-adepis.org/ On targeted: Link to other vulnerable groups On specialist Detailed advice on what should be commissioned Presentation title - edit in Header and Footer

PHE published the 2015-16 young people’s annual treatment stats on 12 Presentation title - edit in Header and Footer

Declining no’s of YP entering treatment (17,077, a drop of 1,272 or 7% compared to 2014-15). Continues a downward trend, year-on-year, since a peak of 24,053 in 2008-09 The most common presenting substance continues to be cannabis. More than four-fifths (87%) of young people had a problem with t compared to 86% in 2014-15. The numbers in treatment for cannabis as a primary substance have been on an upward trend since 2005-06, although numbers have dipped slightly in the last two years Alcohol is the next most commonly cited problematic substance with just under half the young people in treatment (48%) seeking help for its misuse during 2015-16. However, numbers in treatment for alcohol problems have been declining steadily in recent years and this figure is much lower than the two-thirds (67%) reported in 2009-10 Presentation title - edit in Header and Footer

Other substances: 1,605 cited problematic ecstasy use (9%) 1,477 cocaine (9%) 1,152 amphetamine (7%) 1,056 (6%) with concerns around the use of new psychoactive substances (NPS) Not seeing no’s coming into treatment around NPS that perhaps we would expect Main referral routes are via education provision (28%), youth justice services (26%), and children’s social care (14%). The proportion of referrals from the youth justice system have declined in recent years while the proportion of referrals from education has increased Presentation title - edit in Header and Footer

Link with other vulnerabilities Majority of young people in treatment have multiple risks/vulnerabilities: other problems or vulnerabilities (i.e. mental health problems, being ‘looked after’ or not being in education, training or employment ) wider factors that can impact on substance use (i.e. offending, self- harming, experiencing sexual exploitation or domestic abuse) NDTMS collects 7 vulnerability items: 83% have two or more vulnerabilities 59% have three or more 38% have 2 or more Sexual exploitation: Six per cent (6%) in 15-16 compared to 5% in 2014- 15. Significantly higher among females (14%) than males (just over 1%) Presentation title - edit in Header and Footer

Some London specific data   2012-13 2013-14 2014-15 2015-16 London 3,555 3,524 3,363 3,120 % change compared to previous year - -1% -5% -7% National 20,718 19,788 18,949 17,593 -4% No’s in treatment in London have been declining at roughly the same rate as nationally Presentation title - edit in Header and Footer

(marginally) more cannabis and nicotine (marginally) more cannabis and nicotine. Less alcohol, ecstasy, cocaine, amphetamine and NPS than nationally Presentation title - edit in Header and Footer

Young people in treatment in London have less vulnerability factors than nationally Presentation title - edit in Header and Footer

Things that are in the pipeline New government national Drug Strategy is imminent (the last one was 2010 – 2015). We fully expect prevention and treatment to be centre stage (Link to last is https://www.gov.uk/government/publications/drug-strategy-2010) New UK guidelines on clinical management of drug misuse and dependence (updating the 2007 edition) – covers young people (Link to last is http://www.nta.nhs.uk/uploads/clinical_guidelines_2007.pdf) NICE activity updating guidelines on prevention, and alcohol school based interventions CONTACT: jez.stannard@phe.gov.uk 020 3682 0532 Presentation title - edit in Header and Footer