National Institute for Health and Clinical Excellence (NICE)
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New NICE guidance calls for early intervention to support vulnerable young people at risk of substance misuse

The National Institute for Health and Clinical Excellence (NICE) has recently issued new national standards calling for anyone who works with young people to identify those who are vulnerable to drug problems, and intervene at the earliest opportunity - before they start using drugs at all or before they get into worse problems if they are already misusing drugs. The guidance gives advice on stepping in and helping young people access the right support and services, and outlines effective individual, family and group-based support which can improve motivation, family interaction and parenting skills. Vulnerable young people such as those excluded from school, those who have been in care, those whose parents misuse drugs and serious or frequent offenders are on average five times more likely to use illegal drugs than their peers, and there are currently over 70,000 problematic drug users in England between the ages of 15 and 24.

Professor Peter Littlejohns, Clinical and Public Health Director at NICE and Executive Lead for this guidance says: "Young people aged between 16 and 24 years show the highest prevalence of illicit drugs use in the UK, with over 45% having used one or more illicit drugs in their lifetime. Some of these young people will not develop a serious problem; however 24% of vulnerable young people reported using illicit drugs frequently in the last year, compared with 5% of their less vulnerable peers. This guidance will help practitioners working with young people, to understand which interventions are effective and how they should be used with those at high risk of substance misuse. It is important that a national standard is set for tackling this issue so that we can do everything possible to prevent all those at risk, wherever they are, from developing a serious drug problem."

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Professor Mike Kelly, Director of the Centre for Public Health Excellence at NICE says: "Substance misuse does not only affect the individual – it has a huge impact on the rest of society. As well as the increased crime and health risks associated with substance misuse, there are also social costs associated with problematic substance misuse, including poor school attendance and educational attainment, social exclusion and disruption of the family or community - In England and Wales in 2003/04, class A drug use was estimated to cost around £15.4 billion in economic and social terms. It is in all of our interests to tackle this problem at the earliest opportunity so that we can prevent the problem from getting any worse – this has to be a good thing."

Dr Catherine Law of the UCL Institute of Child Health and Chair of the Public Health Interventions Advisory Committee at NICE says: "The good thing about these recommendations is that they can be implemented by any individual whose role involves interacting with young people in their daily work. We are not just looking to healthcare professionals and teachers to spot those who are vulnerable to substance misuse and take action. This guidance can be used by anyone who works in a community setting – for example a youth worker at the local drop-in centre or a probation officer. The UK has some of the highest levels of children using drugs in Europe – we don’t want this problem to get any worse so it is essential that those working with vulnerable young people identify those at risk as early as possible and intervene early."

Professor Mark Bellis, Director of the Centre for Public Health, Liverpool John Moores University said: "Across the UK we are seeing more people going through drug services than ever before. We don’t want to see even more people having to go down this path – what we want to do is get to the problem at the earliest stage. If you can stop people using drugs for one, two or even three years you are giving them a much better chance of getting a good start in life and progressing through school. The interventions suggested are by no means ‘quick fix’ solutions – they involve working with vulnerable individuals and their families over the long-term to address other needs such as problem solving, relaxation and study skills. However, as they are based on the best available evidence, we know that interventions which involve working with families and young people in the long term should have life-long benefits and will work in many cases."

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Notes for editors

  1. 1. The guidance is available at www.nice.org.uk/PHI004 (from 28 March).

About NICE

  1. 2. The National Institute for Health and Clinical Excellence (NICE) is the independent organisation responsible for providing national guidance on the promotion of good health and the prevention and treatment of ill health.
  2. 3. NICE produces guidance in three areas of health:
    1. public health – guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector.

    2. health technologies – guidance on the use of new and existing medicines, treatments and procedures within the NHS.

    3. clinical practice – guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS.

    4. 3. In England and Wales in 2003/04 class A drug use was estimated to cost around 15.4 billion in economic and social terms (Gordon et at. 2006)

  3. 4. The British Crime Survey 2005/06 estimates 526,000 people aged 16-24 years (8.4%) have used a Class A drug (cocaine, ecstasy, lysergic acid diethylamide (LSD), mushrooms, heroin, methadone) in the last year and 1,338,000 people aged 16-24 years (21.4%) have used cannabis in the last year. The National Treatment Agency estimates there are currently 72,791 problematic drug users (opiate and/or crack cocaine users) in England between the ages of 15-24

  4. 5. In England 24% of vulnerable young people reported using illicit drugs frequently in the last year, compared with 5% of their less vulnerable peers (Becker and Roe 2005)
  5. 6. Screening tools include the Common Assessment Framework http://www.everychildmatters.gov.uk/deliveringservices/caf/ and those available from the National Treatment Agency http://www.nta.nhs.uk/.

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