Last week (27 January 2022) the Office for Health Improvement and Disparities published its annual statistics on young people’s substance misuse treatment for the financial year 2020/21. As in all areas of life, the impact of the pandemic was clear. In particular, school closures and reduced face-to-face contact across all children and young people’s services meant there were fewer opportunities for young people to be referred to substance misuse services. There were 11,013 young people in contact with alcohol and drug services between April 2020 and March 2021, a 23% reduction from the previous year (14,291) and a staggering 55% reduction in the number in treatment since 2008 to 2009 (24,494).
Cannabis remains the most common substance (89%) that young people come to treatment for. Around 4 in 10 young people in treatment (41%) said they had problems with alcohol, 12% had problems with ecstasy and 9% reported powder cocaine problems.
The proportion of young people seeking help for heroin was the same as last year, at 0.4%. However, the proportion of those with codeine problems has doubled from 2018 to 2019 (0.6% compared to 1.2% this year).
Following a 19% decrease between 2018 and 2020, this year saw a small increase in young people reporting a problem with benzodiazepines. This proportion (3.7%) was over 5 times the proportion in 2013 to 2014 (0.7%). For more info, see the chart reproduced below.
The most common vulnerability reported by young people starting treatment was early onset of substance use (73%), which means the young person started using substances before the age of 15. This was followed by poly-drug use (53%).
Proportionally, girls tended to report more vulnerabilities than boys, particularly self-harming behaviour (46% compared with 15%) and sexual exploitation (12% compared with 2%).
Over two-fifths (43%) of young people starting treatment this year said they had a mental health treatment need, which continues the rising trend of the last 2 years (37% in 2019 to 2020 and 32% in 2018 to 2019). A higher proportion of girls reported a mental health treatment need than boys (58% compared to 36%).
Most young people (68%) who had a mental health treatment need received some form of treatment, usually from a community mental health team.
Of the young people who left treatment, 79% left because they successfully completed their treatment programme, which is slightly lower than the previous year’s proportion (82%). The next most common reason for leaving treatment (15%) was leaving early or dropping out, slightly higher than the previous year (12%).
Age and gender
There were 11,013 young people in contact with drug and alcohol services between 1 April 2020 and 31 March 2021. Two-thirds were male (66%), similar to the previous 2 years. The median age was 16 years old for both boys and girls. The number of younger children (under 14) in treatment remained relatively low (740, 7%).
The most common route for young people to get into specialist treatment services was a referral from social care services. The proportion of people entering treatment this way was higher than the previous year (25% compared with 18% in 2019 to 2020), despite the number remaining stable (1,748 in 2019 to 2020 and 1,743 in 2020 to 2021). This is because of a large fall in referrals from other sources, likely because of the COVID-19 pandemic.
Referrals from the youth justice system were the second largest source of referral (25%, 1,705). Education services (such as mainstream education or alternative education) accounted for 19% of referrals, but the number of these referrals (1,284) dropped by 60% from the previous year. Other routes included referral by self, family or friends (12%, 867), health services (12%, 863) and other substance misuse services (5%, 333).
Most young people in treatment received a psychosocial intervention (10,881 of 11,013, 99%). The small number who did not receive an intervention probably entered treatment at the end of the time period covered by this report, and so had not started their intervention yet. Psychosocial interventions (also known as talking therapies) use psychological, psychotherapeutic and counselling skills to encourage behaviour change.
Structured harm reduction interventions are a type of psychosocial intervention. They involve support to manage risky behaviours associated with substance misuse. This might include behaviours that can cause overdose or accidental injury, for example injecting and poly-substance use. In 2020 to 2021, 7,174 young people (66% of those receiving an intervention) received a harm reduction intervention.
Only 28 young people in treatment (less than 1%) received a pharmacological intervention during treatment. These interventions involve medication prescribed by a clinician and can include detoxification, stabilisation, relapse prevention, and substitute prescribing for opiates.
Almost all interventions were delivered in a community setting (98%). A small number of young people received interventions in other settings, such as at home, in residential rehab, or in an inpatient unit.
The most pronounced trend is the continuing drop in the number of young people engaging in drug & alcohol treatment, accelerated by the effects of COVID-19. There has also been a bigger drop in the number of young people accessing help for their drinking. The proportion who reported having alcohol problems has fallen steadily from a peak of 68% in 2008 to 2009 to 41% in 2020 to 2021. The proportion of young people in treatment who said that they had problems with cannabis has been between 85% and 90% since 2013 to 2014. The proportion of young people in treatment whose main problem substance was something other than cannabis or alcohol has consistently been around 10% for the past 10 years of reporting.
It will be important to see whether the Black Report and the Government’s new drug strategy results in more young people accessing services in years to come.
Thanks to Tobias Tullius for kind permission to use the header image in this post which was previously published on Unsplash.
Thank you for sharing these statistics. They were informative.