The changing pattern of teenage drug and alcohol misuse

    Concerns about young people binge drinking and using drugs are growing as figures reveal more children are being treated for substance misuse. Meanwhile, charity Drinkaware’s latest survey suggests teenagers drink mainly to relieve boredom. Louise Tickle reports

    The news last month that a 22-year-old man had died of liver cirrhosis after starting to binge-drink at the age of 13 came hot on the heels of figures from the National Treatment Agency showing that far more children are being treated for drug and alcohol misuse than ever before.

    Although the NTA figures prompted a media furore, closer inspection of the data reveals a somewhat more nuanced picture of how children and young people are using drugs and alcohol.

    “It’s important to note that, while numbers in treatment appear to have gone up since 2005, this does not necessarily reflect an increase in the number of young people experiencing a dependency, but rather an expansion in the availability of drug treatment as a whole,” says Martin Barnes, chief executive of drugs charity DrugScope.

    Neither does being “in treatment”, in the NTA’s parlance, mean that a child or young person is addicted, or that they have done anything more than attend an advisory session with a drugs worker, he adds.

    The NHS Information Centre’s report on smoking, drinking and drug use among young people in England 2008 published last month actually shows a fall in reported drug use among 11- to 15-year-olds to 22% from 30% in 2003.

    The numbers of children reporting use in the past year of Class A drugs, stimulant drugs and glues, and aerosols or solvents were all down. So too was cannabis use, from 13.4% in 2001 to 9% in 2008, though it is still the most commonly used drug in this age group.

    Numbers drinking down

    The proportion of 11- to 15-year-olds drinking has also declined. However, 60% of those who did drink tended to consume more than four units in a single session, and 63% of 15-year-olds who had consumed alcohol in the previous four weeks had got drunk.

    For 16- to 24-year-olds, though, the picture is worse. Results from the 2008/9 British Crime Survey show a 1.5 percentage point rise in 16- to 24-year-olds using cocaine last year. This is the highest level since 1996 and equivalent to one in eight people in this age group having used cocaine.

    There’s also been a 1% rise in the same group’s use of ketamine, and the numbers of 16-to 59-year-olds using cannabis. is up by eight percentage points.

    Bingeing combinations

    But it’s not simply the fact young people are using drugs and alcohol that is causing grave concern, but the way they are combining them and bingeing on different types of alcohol in a single session.

    “Alcohol is definitely becoming more problematic, and the concern for me is the mixing of other substances with alcohol,” says Debbie Simmons, project manager at the charity Disc. “It leads to offending, memory loss and then to dangerous sexual behaviour, teenage pregnancy. The effects can be disastrous.”

    Different approaches

    So what steps are being taken to try and stop children from misusing alcohol and drugs? One approach being campaigned for by Alcohol Concern is the introduction of a minimum price for a unit of alcohol.

    “University of Sheffield research released in December looked at the relationship between price and consumption,” says Alcohol Concern chief executive Don Shenker. “We’re now recommending a minimum price of 50p per unit, as does the chief medical officer for England.

    For those children already deemed to have a substance misuse problem, Barnes welcomes the expansion in specialist services for young people, but warns there is some “variability in quality.”

    Paula Harrison, team leader for Addaction, which works with young people in central Lancashire, points out that many young people with a substance misuse problem won’t have an established addiction in the same way an adult might.

    Problematic use

    Rather, Harrison’s project is commissioned to take on any young person who has what they feel is “problematic use”.

    “That could be heroin every day or a couple of spliffs a week,” she says, adding that being able to work within that broad remit allows her workers to help children before they do themselves irreparable damage.

    For those who need intensive round-the-clock therapy, complete rehabilitation services are few and far between. There is just one five-bed unit in the country – Middlegate in Lincolnshire – exclusively devoted to detoxing children. And even this has come under threat of closure recently.

    “It costs £3,600 a week for the specialist skills that these children need,” says Fred Henry, one of Middlegate’s directors.

    While Henry is clear that treating children in their normal environment is best for most children, he insists there will always be a percentage who need to get away. “A few years ago, the NTA said that 5% of young people will need residential treatment,” he says. “That’s a lot more than the five young people we can cater for.”

    * Not her real name

    Specialist drug support worker made the difference

    Case study: JO, an ex-drug user who went through a recovery programme

    Jo* was just 14 when her mother committed suicide after enduring years of domestic abuse. Taken into care after the abuse transferred to her, at 16 Jo began taking heroin.

    From that point on, Jo’s life chances seemed to drain away. At 19, her four-month-old son was taken into care after she was judged unable to look after him, despite having worked hard to come off heroin and being stable on methadone.

    “I went to various drug treatment agencies but I wasn’t getting the right support,” she says. “They see it every day, and they assume things about you.”

    Turning Point

    Meeting Tania Gauci, a specialist drug support worker for the charity Catch22, was a turning point. Refusing to see her as an addict, and instead choosing to relate to her as a person who had become addicted due to the pain of traumas in her past, Gauci worked with Jo for the six months it took to rebuild her life without drugs.

    “We work relationally, which is a term used in therapy and now being introduced into social work settings,” Gauci says. “It means that the quality of the relationship you build is critical to the outcome. It’s about consistency and continuity – and letting them know you care.”

    Terrified of relapse

    Jo was terrified of telling Gauci she had started to relapse after coming off heroin for fear this would be reported back to social services and that her son would never be allowed home.

    “That terror feeds the craving,” Gauci says. “So we spent a long time talking through that.”

    Meeting every two weeks for a nominal period of an hour, the two were able to slowly work through the issues that gave rise to Jo’s use of heroin.

    Her progress was recognised by social services just as her recovery programme was coming to an end, and her son was returned to live with her. Now aged 21, drug-free, and with a supportive partner, Jo has a baby girl, and the chance of a happy future.

    More information

    Smoking, drinking and drug use among young people in England 2008:

    Drug misuse declared: Findings from the British Crime Survey 2008/09

    First comprehensive picture of drug and alcohol treatment for young people in England

    Published in the 6 August 2009 edition of Community Care under the heading Under the Influence

    Picture credit: Alamy

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