YOUNG PEOPLE

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Properly addressing co-morbidity in child and adolescent substance misuse treatment can have extraordinary results , says Stuart Croft

tabloid headline writers may think , the majority of young people in the UK are not perpetual or problematic users of alcohol and illegal drugs – although a significant proportion have tried alcohol or drugs during their lifetime . However , for those who find themselves in difficulties , whether as a result of experimenting with risk-taking behaviours ( part of growing up ) or something more sinister – such as exploitation at the hands of county lines gangs – the support available needs to be joined-up , effective and well resourced .

Those young people for whom alcohol or drugs become a serious problem are likely to have been exposed to risk factors such as abuse and neglect , parental substance use , chaotic environments , social exclusion or poor mental health . The single strongest predictor of the severity of a young person ’ s substance misuse problems is the age at which they start using substances . According to Lankelly Chase ’ s Women and girls at risk report , responses to adversity , including abuse , tend to be different according to gender . Boys are more likely to externalise problems and to act out anger and distress through antisocial behaviour , and girls to internalise their responses in the form of depression and selfharm . Substance misuse services for young people may need to consider these gender issues .

THE TOLL OF TRAUMA The impact of such adverse experiences can be profound . According to an article in the Lancet , four per cent of 10 to 19-year-olds experience an emergency admission to hospital due to an injury that is self-inflicted , drug or alcoholrelated or due to violence . Of these , 7.3 per 1,000 girls and 15.6 per 1,000 boys died within ten years of their first such hospital admission , with suicide , drug- or alcohol-related deaths , and homicides accounting for 64 per cent of these fatalities . The toll that childhood trauma is taking on young people ’ s lives is shocking .

The public health response , quite rightly , has a focus on prevention and early intervention . At a universal level , evidence suggests that prevention approaches that set out to reduce risk and increase resilience are most effective . These approaches focus on such factors as family stability , improving educational attainment , training and employment , and promoting positive health and wellbeing , positive relationships and meaningful extra-curricular activities . Opportunities presented through personal , social , health and economic education ( PSHE ) and relationships and sex education ( RSE ) allow for a ‘ wholeschool ’ approach that includes engagement with parents and families . This approach aims to equip young people with the skills and resilience they need to make healthy choices .

Intervening with addiction

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12 • DRINK AND DRUGS NEWS • OCTOBER 2023 WWW . DRINKANDDRUGSNEWS . COM