Correspondence

ACMD letter on young people's drug use (accessible)

Published 9 December 2022

ACMD Chair: Professor Owen Bowden-Jones

Young People Working Group Secretary: Matthew Brace

1st Floor (NE), Peel Building
2 Marsham Street
London
SW1P 4DF

ACMD@homeoffice.gov.uk

Rt Hon Chris Philp MP

Minister of State for Crime, Policing and Fire
2 Marsham Street
London
SW1P 4DF

9th December 2022

Dear Minister,

RE: ACMD Vulnerable Groups- Young People’s Drug Use

The Advisory Council on the Misuse of Drugs (ACMD) agreed in 2019 to begin a self-commissioned workstream investigating young people’s drug use. The ACMD has discussed young people’s drug use in previous reports, including in ‘Hidden Harm’ (2003), ‘Prevention of Drug and Alcohol Dependence’ (2015) and ‘Drug Misuse Prevention’ (2022). The ACMD has also considered vulnerability to drug dependence in ‘What are the risk factors that make people susceptible to substance misuse problems and harms?’ (2018) and young people have been identified as a group where vulnerability to drug use may be more common.

The Government’s 10-year drug strategy (2021) ‘From Harm to Hope’ highlighted the importance of building a world class evidence base, reducing the demand from drugs in adults and preventing the onset of drug use among children and young people.

The ACMD has therefore also considered how the recommendations below can support the objectives outlined within the strategy.

The ACMD has reviewed the information gathered and concluded the available evidence was limited and variable in quality. It would be challenging to produce a full report with meaningful recommendations at this stage. Instead, the ACMD has produced this letter which outlines the key findings to date, important developments in the field and contains recommendations to guide where future work should be focused. The ACMD is open to producing a full report into young people’s drug use in the future when the available evidence would facilitate doing so.

What we did

• The ACMD’s Recovery Committee undertook a review of research evidence published since 2007, together with a structured search of health and social care data to inform an estimation of the prevalence of the problem.

• The review also considered the literature relevant to the commissioning of treatment.

• The ACMD issued a public call for evidence and held two evidence-gathering days in 2020, with a further evidence gathering session in 2021. Twenty submissions were provided by a range of stakeholders across the UK, including NHS trusts, voluntary sector treatment providers and Government departments.

Key findings

• Drug use within the general adult population was generally lower than, or at similar levels to 20 years ago (Crime Survey for England and Wales (2021)).

• There has been increased drug use over the last six years among the under 30s and those of school age (Crime Survey for England and Wales (2021)).

• Trends in England and Wales cannot be easily translated to Scotland and Northern Ireland. The Scottish Schools Adolescent Lifestyle and Substance Use Survey in Scotland (last updated in 2018) and Young Persons’ Behaviour & Attitudes Survey in Northern Ireland (last updated in 2019) have collected data on young people’s drug use. However, these data did not cover the time contemporaneous with the apparent recent increase in prevalence in England.

• The prevalence data within the UK were generally limited, highly variable and of low quality. The Crime Survey for England and Wales is not methodologically appropriate to provide enough information on young people’s drug use.

• Evidence regarding the effectiveness of available treatments or engagement with relevant service providers was limited. This is particularly the case for those who are not in structured treatment (for example, local authority commissioned services). This could be due to several reasons, for example, because young people’s substance use was less problematic and/ or the availability of treatment options.

Recent developments in young people’s drug use research

The National Institute for Health and Care Research (NIHR) has recently funded the Liverpool John Moores University AMOUNT study^{[footnote 1]}. This study aims to develop and test theories to identify the factors, contexts and putative causal mechanisms underlying recent increases in substance among some groups of young people, mainly ages 12-18 years. The AMOUNT study is due to publish results in 2023.

The Department for Health and Social Care (DHSC) has also recently published a report considering the effectiveness of drug and alcohol treatments for young people (Exploring the use of drug and alcohol interventions that target young people at-risk (2022)). The key conclusions from this report were consistent with those found by the ACMD as part of this project. There were some staff and service providers who were successful but little systematic evidence of what worked, and that coverage may not be universal.

Recommendations

The ACMD has made the following recommendations:

Recommendation 1

The ACMD proposes the research questions below should be considered to understand young people’s substance use, service engagement and the effectiveness of available treatments:

• What are the needs of young people and are these being met in services?

• What was the impact of reduced funding (£26 million- 37% in real terms) for young people’s services since 2013/2014?

• Did the reduced funding for young people’s services contribute to the reported increase in drug use? Was the reported increase in drug use proportionate to this reduction in funding?

• What are the most effective interventions, treatments and service models to reduce drug-related harm in young people?

• How do individuals transition from ‘young people’ to ‘adult’ treatment services?

Recommendation intended for

Department for Health and Social Care, National Institute for Health Research, Department for Education, Scottish Government, Public Health Wales, Public Health Agency Northern Ireland.

Measure of impact

Increasing number of research studies investigating the above research questions.

Recommendation 2

To improve the quality of data on young people’s drug use, increased qualitative data on the patterns and types of drug use should be collected. These qualitative data should also consider young people’s drug use and mental health. For example, qualitative data on non-fatal overdose, drug-related deaths and suicidality should be collected.

Recommendation intended for

Department for Health and Social Care, National Institute for Health Research, Department for Education, Scottish Government, Public Health Wales, Public Health Agency Northern Ireland.

Measure of impact

The number of research studies collecting qualitative data on young people’s drug use.

Recommendation 3

The ACMD proposes quantitative approaches to measure young people’s drug use:

• The scope and detail of the current approaches to monitor prevalence and outcome measures should be reviewed to ensure they are adequate.

• There should be greater focus on reporting and data on young people who are not in structured treatment.

• A core data set across England, Wales, Scotland, and Northern Ireland should be developed.

• An international comparison study comparing the prevalence and outcome measures should be undertaken.

Recommendation intended for

Department for Health and Social Care, National Institute for Health Research, Department for Education, Scottish Government, Public Health Wales, Public Health Agency Northern Ireland.

Measure of impact

The number of research studies collecting quantitative data on young people’s drug use. Increased national standardised outcome measures for young people approaches.

Yours sincerely,

Professor Owen Bowden-Jones, Chair of the ACMD

Dr Emily Finch and Dr Anne Campbell, Co-Chairs of the ACMD Recovery Committee

1. AMOUNT: A mixed methods investigation of the individual, sociocultural, and societal factors that underlie the recent increase in substance use among young people to inform policy - NIHR Funding and Awards ↩