1. New 2013 CYPP priority OUTCOME : CYP choose healthy lifestyles:
To minimise the misuse of Children and Young People’s Drugs, Alcohol and Tobacco

2. The national picture and the evidence base
Wayne Sivyer
PHE Yorkshire & The Humber
The New 2013 Priority for the Children and Young People Plan:
Minimising the misuse of drugs, alcohol and tobacco
Leeds 1st October 2013

3. Who we are
In April 2013 the NTA became part of Public Health England (PHE), an executive agency of the Department of Health.
Alcohol & drugs and children, young people and families are two of the key priorities for PHE:
PHE promotes a balanced and ambitious substance misuse treatment system and supports local commissioners by providing high quality information and intelligence about drugs and alcohol, expertise, bespoke support, and by benchmarking performance and sharing best practice.
In its priorities document for , PHE recognised that giving every child and young person the best start in life, and intervening early where necessary, maximises their potential and ensures that ‘society as a whole can reap all the benefits of a resilient next generation’.
The national picture and the evidence base Leeds October 2013

4. National alcohol and drug strategies
To provide good quality, evidence-based and effective education and advice so that young people and their parents have access to credible information to actively resist substance misuse
To prevent the escalation of use and harm, including stopping young people from becoming drug or alcohol dependent adults
For those whose drug or alcohol misuse has already started to cause harm, or who are at risk of becoming dependent, ensure rapid access to specialist support that tackles their substance misuse alongside any wider issues that they face
For those very few young people who develop dependency, to support them to become drug or alcohol free
Drug Strategy 2010/ Alcohol Strategy 2012
The national picture and the evidence base Leeds October 2013

5. Trends: surveys
Key findings of Smoking, drinking and drug use among young people (aged 11-15) in 2012 include:
fewer young people taking drugs, drinking or smoking with the lowest drug using rates recorded in over a decade;
however, the proportion of young people drinking in England is still well above the European average;
of those who do drink, consumption rates are up, with a spike in consumption among 14 year olds (higher than among older pupils);
North East has the highest rates of ‘ever smoking or drinking’, London the highest rates of ‘ever taken drugs’.
Health and Social Care Information Centre July 2013
The national picture and the evidence base Leeds October 2013

6. Trends: surveys
Key findings of Drug Misuse: Findings from the Home Office 2012/13 Crime Survey for England and Wales include:
frequent drug use among young adults (16 to 24) has continued to decline along with the proportion of young adults taking any drug;
levels of any drug use were highest among young adults aged 16 to 19 (16.4%) and 20 to 24 (16.2%);
while cannabis is the most prevalent illicit drug used across all age groups, use peaks among 16 to 19 year olds;
the long-term decline in Class A drug use among young adults continues;
illicit drug use varied by lifestyle factors such as frequency of nightclub and pub/wine bar visits and alcohol consumption.
The national picture and the evidence base Leeds October 2013

7. Trends: treatment
Substance misuse among young people will be released in December
Early headlines:
The number of young people accessing treatment has declined for the fourth consecutive year from a peak of more than 24,000 to 20,000
The proportion of young people leaving treatment in a planned way continues to increase
Class A drug use remains low and has declined further
Primary alcohol use dropped
Primary cannabis use has increased
Reported amphetamine use has increased (primary and adjunctive)
The national picture and the evidence base Leeds October 2013

8. National treatment data 2012/13
Primary substance among young people accessing treatment: 2% heroin & crack 21% stimulants (cocaine, Ecstasy, amphetamines, NPS) 34% cannabis & alcohol 30% cannabis only 12% alcohol only 1% other drug While anecdotal accounts and media reports indicate very high levels of new psychoactive substance misuse (e.g. of mephedrone), currently this is not reflected in the data received from treatment services.
The national picture and the evidence base Leeds October 2013

9. National treatment data 2012/13
80% of young people accessing treatment were aged 15 or over
2:1 ratio male to female
12% were Looked After Children
4% were recorded as involved in sexual exploitation
96% presented with at least one additional risk/vulnerability, with 72% reported as having two or more
99% were seen within 3 weeks of referral, with the vast majority seen in a very much shorter timeframe
73% were in treatment under 26 weeks
79% left treatment in a planned way
The national picture and the evidence base Leeds October 2013

10. Evidence base, practice standards & guidelines
The national picture and the evidence base Leeds October 2013

11. Investment
Funding for specialist substance misuse interventions is available via the Public Health Grant
Additional funding for early interventions targeted at specific groups of young people deemed to be more at risk of escalating substance misuse is available through the Business Rates Scheme (formerly the Early Interventions Grant)
Local funding may be available, via the Police and Crime Commissioner, to provide substance misuse and youth crime prevention initiatives
Maintaining investment is important to ensure the continued availability of early identification, targeted support and onward referral as appropriate, as well as specialist interventions
The national picture and the evidence base Leeds October 2013

12. Cost-effectiveness & value for money
A Department for Education cost-benefit analysis found that for every £1 spent on young people’s substance misuse services, there is a saving of around £2 over a two-year period and up to £8 over the long term
Evidence indicates that investing in specialist interventions is a cost effective way of securing long-term outcomes, reducing future demand on health, social care and mental health services, and supporting the Troubled Families agenda
Research Report DFE-RR087
The national picture and the evidence base Leeds October 2013

13. Effective young people’s substance misuse services
Key components:
Strong local strategic leadership, with clear lines of accountability, which can demonstrate that services are outcome-focused, efficient and effective;
Services that are delivered within an integrated support package along with wider children’s services to engage young people early and minimise risk and harm;
High-quality, age-appropriate and evidence-based substance misuse interventions;
A skilled workforce to deliver the services.
The national picture and the evidence base Leeds October 2013

14. The national picture and the evidence base wayne.sivyer@phe.gov.uk

15. Chief Inspector Jones
Safer Leeds

16. Legal Highs
Head shops have in recent months become specialists in ‘legal highs’ and to avoid being controlled by the
Medicines Act or Misuse of Drugs Act 1971 they are advertised and marketed as "Research Chemicals”
and not for human consumption,
however they are widely used as legal alternative to controlled drugs
and have similar damaging effects.

17. The Law
It is an offence to supply any intoxicating substance to anyone under 18. These articles fall under this offence.
It is not an offence to possess these articles, however should officer suspect the product may contain a control drug you could be arrested.
Many drug users are now disguising controlled drugs such as Ecstasy, cocaine and Mcat in legal high packaging.
Many ‘Legal Highs’ are being considered by the government for temporary banning orders which could make them controlled drugs with little notice.

19. Health issues RESEARCH CHEMICALS !!!!
Legal highs can carry serious health risks. The chemicals they contain have in most cases never been used in drugs for human consumption before, so haven't been tested to show that they are safe. Users can never be certain what they are taking and what the effects might be.
Children and Young People are dying taking these substances

21. More information

22. Recent Success
All Leeds market traders served with warning notices by LCC
Two convictions for selling intoxicating substances to under 16’s
Report for summons for selling articles linked to drugs
Positive press interest

23. Substance Misuse in Leeds A Service Perspective
Dr Susanna Lawrence
Specialist GP
Platform Young Peoples Substance Misuse Service
Executive Clinical Director
Leeds Community Drug Partnership (Adults)
October 2013

24. Substance Misuse Profile
Heroin and crack use all but disappeared (for now) opiates remain
Alcohol biggest concern
Legal highs esp MCAT
Prescribed/OTC medication (inc opiates)
Benzodiazepines (‘valium’)
(anabolic steroids/image enhancers)
Polysubstance use
Unknown substance use

25. Client profile Most clients 14-18 White indigenous
Eastern European immigrant (different drug profile)
History of
childhood abuse
Family substance misuse esp alcohol
Young women: association with grooming
VERY high risk lifestyles

26. What’s good about current configuration and services
Platform - National flagship
Extremely skilled workforce
Outreach
Ready access to clinical team
CAMHS worker part of the team
Collaboration with other services

27. What’s concerning about current configuration and services
Highly vulnerable clients dropping through safeguarding net
Children-adult service gap
Still high unmet need in Leeds
Threat of future configuration increasing caseloads.

28. Looking to the future Sector Review –retender 2015
Better protection for young people
Specific consideration for young adults (16-25years)
More integrated approach with key families
Outreach into under-represented communities

29. Children and Young People’s Drugs, Alcohol and Tobacco Misuse Local Data

30. C&YP
Alcohol Misuse
Leeds rates of young people drinking:
2% higher than national rates
Similar to our statistical neighbours

31. Under 18’s alcohol specific hospital admission rates
There is an on-going problem of young people being admitted to hospital due to alcohol related harm
Though numbers are small they also reflect much larger numbers of young people attending A&E due to alcohol
This is a major concern for health services

32. Leeds Trends A fifth of young people aged
11 – 16 years reported being drunk in the last 4 weeks
More YP are choosing not to drink
However when YP are choosing to drink they are consuming high levels of alcohol leading to increased drunkenness (binge drinking)
Data from Growing up in Leeds Survey

33. Smoking and Young People
The number young people who have ever smoked a cigarette has been slowly reducing in the last five years.

34. Children and young people who live with parents or siblings who smoke are up to three times more likely to become smokers themselves than children in non-smoking households

35. Smoking and Inequality
Smoking rates are linked to deprivation.
A higher number of pupils receiving free school meals live with a smoker compared to the Leeds average.
There is a strong association between smoking and drug/alcohol misuse.
If a child is from a deprived area they are more likely to smoke and live with a smoker, thus likely to be exposed to more second hand smoke.

36. Substance cited in first three drugs used in any one episode
Number
Percentage
National %
Cannabis
228
89%
83%
Alcohol
172
67%
59%
Amphetamine 80
31%
11%
Cocaine 38
15% 5%
Solvents 8 3% 2%
Opiates 4 1%

37. Cluster OBA Planning …..for Drugs Alcohol & Tobacco Plans – 3-5 years?
Menu of Activities – best practice for localities
Open XS Cluster vanguard starts Nov ‘13
Support to get started available through Health and Wellbeing Service