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Substance misuse

Young people’s substance misuse: changing beyond recognition

Young people dance in a darkened room. None of their features are visible due to the lighting.

Tracy Scares, Senior Service Manager for all of Catch22’s substance misuse services tells us about the changes she has seen in substance misuse throughout her career, and what we need to see to better support young people affected by substance misuse.

I started working at Catch22 in 2019 as a senior practitioner for Surrey Young People’s Substance Misuse Service (SYPSMS), before becoming service manager and then senior service manager for all of Catch22’s substance misuse services. I have an MA in Youth and Community Work, a Youth Justice Board Professional Certificate in Effective Practice, and a Certificate in Drug Interventions with Young People through Manchester University. Before joining Catch22, I worked for a local authority for 25 years in both operational and strategic roles across a range of services, including mental health, substance misuse, youth justice and early help.

In addition to my full-time role/s, for the past 20 years I have worked part time as the Lead Youth and Community Worker based in the middle of a housing estate ranked in the top three most underprivileged wards within that borough.

This has given me a privileged insight into the changing trends and patterns in young people’s substance misuse; a landscape that in my view has changed beyond recognition.

Young people too often an ‘add-on’

For too long we have ‘tagged on’ young people’s substance misuse to adult treatment, rather than recognising it for delivering specialist psychosocial interventions based on a harm reduction approach, which evidence tells us is most effective when working with this cohort.

Within Dame Carol Black’s Independent Review of Drugs report, there are 33 recommendations, yet only two mention young people.

The Government’s 10-year Drugs strategy, ‘From Harm to Hope’, makes some reference to young people’s substance misuse, however it appears to focus on adult treatment at one end of the scale, and prevention at the other. It is noteworthy that the strategy highlights the need to tackle ‘recreational drug’ use, with ‘new penalties for drug users’, however this again appears linked primarily to adult recreational users rather than young people.

Living in a drug-taking society

The additional and much welcome funding brings long needed opportunities to provide a ‘world class treatment service’. However, my fear is that unless we are prepared to look at the issue of substance misuse in the context of ‘living in a drug taking society’, and we do not openly talk about and recognise that young people by their very nature will partake in risk taking, pushing boundaries, and experimentation, then we are setting young people and young people’s services up to fail, or at best to achieve limited success.

Our substance using young people of today are tomorrow’s entrenched adult users of the future. To ignore the need for a realistic, standalone, and targeted approach to children, young people’s and young adults’ substance use services, is, I believe, both short sighted and naïve.

Cannabis is reported nationally to be the third most used drug, after heroin and crack cocaine, associated with County Lines; however, at the same time, cannabis has become more ‘normalised’ within society. National and local data shows that cannabis remains the most prevalent illicit drug used by children and young people (CYP), yet nationally we are seeing a reduced number of referrals for under 18s with problematic cannabis use. Professionals tell us that they are dealing with conflicting priorities and safeguarding needs, and that cannabis and/or substance misuse may not be seen or acknowledged as being problematic.

Confused messages

All of this is set within a context of confusing and contradictory messages, reinforced by the media. For example, there’s the increasing popularity of ‘cannabis edibles’, which are marketed specifically at children and young people and contain THC (the active ingredient in cannabis). This is set in the context of a society that increasingly recognises and promotes the benefits of CBD (another active ingredient in cannabis) products, which can be legally purchased from a variety of reputable retailers. Young people are less likely to make the distinction between THC and CBD, and are regularly reporting that the promotion of CBD related products, contributes to their view that cannabis is “not that bad”.

At the same time, we’re being warned in national newspaper articles that “high-strength skunk causes about a third of the psychosis cases the Professor sees at his practice in south London. Most involve young people, many of whom suffer debilitating paranoia and hallucinations”.

In my considerable experience of young people, cannabis, and mental health, I have absolutely no doubt that adolescents are indeed at increased risk of other mental health problems.

Time to get real

In my opinion, based on many years of frontline delivery, academic research, and lived experience, we continue to ignore the fact that we are a drug taking society, and as such we do not actually judge the substance use itself, we judge the context in which it is used. For example, not so many years ago the pharmaceutical world was competing to produce an ‘obesity wonder pill’, which will have contained similar chemical compounds to amphetamine.

We prescribe anti-depressants and ADHD medication to young people, which in my experience they report makes them feel like ‘zombies’. However, if they choose an illicit substance to self-medicate, which has fewer side effects for them than the prescribed medication, we will potentially criminalise them.

At Catch22, we provide a world class treatment service bespoke to children, young people, and young adults. Yet we, along with other young people’s substance misuse services, are trying to fit into an ‘adult’ treatment model, in the context of a society that remains contradictory, out of touch and does not ‘fit’ with the political agenda that appears to ignore the realities of drug and alcohol use within 21st century.