National statistics

Alcohol and drug treatment for young people: statistics summary 2017 to 2018

Published 6 December 2018

This National Drug Treatment Monitoring System (NDTMS) statistics report presents information about young people under the age of 18 who received specialist substance misuse treatment in England between 1 April 2017 and 31 March 2018.

1. The number of young people in alcohol and drug specialist services

There were 15,583 young people in specialist substance misuse services in 2017 to 2018. This was a 5% decrease from 2016 to 2017 (16,436) and a continuation of a year on year downward trend. There has been a 35% decrease since a peak in 2008 to 2009 when 24,053 young people received treatment.

There are several factors which may have influenced this downward trend including the possibility that it reflected historic declining prevalence. However, there is recent evidence that the number of young people using drugs has started to increase, so the more recent decreases in young people accessing treatment services might not reflect the actual need.

The latest NHS Digital survey of school-age children, conducted in 2016, showed that nearly a fifth (18%) of pupils said they had taken drugs in the last year. Excluding new psychoactive substances and nitrous oxide (which were added to the report in 2016), 15% said they had taken drugs in the last year, up from 10% in 2014.

The Crime Survey for England and Wales 2017-18 also showed an increase in any class A drug use in the last year among 16-to-24-year-olds, going from 6.8% in 2007 to 2008 to 8.4% in 2017 to 2018.

In addition to these surveys, Department for Education data for 2016 to 2017 showed school exclusions for alcohol and drug use have increased substantially in recent years with fixed term exclusions up by 34% since 2012 to 2013 and permanent exclusions up by 95% since 2010 to 2011.

2. Problem substances

Cannabis remained the most common drug by far which young people came to treatment for. The majority (88%) of young people in specialist services said they had a problem with this drug. The proportion of young people in treatment saying that cannabis is their main problem substance has been on an upward trend from 2007 to 2008. Although total numbers have decreased slightly in recent years, the proportion of young people in treatment who have cannabis problems has remained stable in the last 2 years at 77%.

The next most commonly reported problematic substance was alcohol. There were 7,206 young people in treatment for alcohol problems (46%). The number of young people receiving help for alcohol problems continued to steadily decline from the peak in 2008-09 when 16,047 were treated for alcohol.

The number of young people entering treatment for problems with ecstasy in 2017 to 2018 increased by 16% from the previous year (1,815 to 2,112) and has almost doubled since 2013 to 2014. The increase in ecstasy treatment numbers was seen across all age groups.

There was also an 18% increase in young people in treatment for crack problems over the same period, although the numbers were much lower (83 in 2016 to 2017 and 98 in 2017 to 2018). The adult alcohol and drug treatment statistics showed a rise in adults being treated for crack over the same period.

Benzodiazepine treatment is reported for the first time in this report. Young people who had problems with benzodiazepines at the start of treatment almost doubled from the previous year (from 161 in 2016 to 2017 to 315 in 2017 to 2018). Alprazolam (most commonly called Xanax) was the benzodiazepine which saw the biggest increase (from 8 in 2016 to 2017 to 53 in 2017 to 2018).

The number of young people entering treatment for problems with new psychoactive substances (NPS) more than halved since the previous year (585 in 2016 to 2017 and 270 in 2017 to 2018) and is 74% lower than 2015 to 2016 when 1,056 reported problematic use. Similar falls were seen in numbers of adults starting treatment over the same period, particularly in those under 25.

3. Gender and age

Two-thirds of the young people accessing specialist substance misuse services were male (66%). Around three-quarters (74%) were aged 15 or over. The median age for both females and males was 15 years old. Only 43% of females were aged 16 or over compared to nearly half (49%) of males.

While the number of younger children (under 14) in treatment remains relatively low, it increased from the previous year (1,342 in 2016 to 2017 to 1,422 in 2017 to 2018).

Any substance misuse among young people – particularly the younger age groups – is concerning because they are likely to be at risk of other harms as well as their alcohol or drug use. Safeguarding needs to be a priority and the other risks and harms need to be addressed.

4. Referral routes

Education services were the most common route into specialist treatment services, with 5,178 (31%) young people being referred from these. Mainstream education was the single largest source of referral, accounting for over a quarter of all referrals (26%, or 4,432). The proportion referred by education services has increased over recent years (24% in 2012-13), while referrals from the youth justice system continue to decline (34% in 2012 to 2013 to 22% in 2017 to 2018).

5. Vulnerabilities

The majority of young people in specialist substance misuse services have other problems or vulnerabilities related to their substance use, such as:

• having mental health problems
• being in contact with children’s social care
• not being in education, employment or training (NEET)
• offending
• self-harming
• experiencing sexual exploitation
• domestic abuse

There are 17 vulnerability items collected via the NDTMS. Almost all (96%) young people who entered treatment in 2017 to 2018 disclosed 1 or more vulnerability, and 55% said they had 3 or more. This shows that specialist services need to work effectively with a range of other agencies to ensure that all the needs of a young person are met.

The number and proportion of young people saying they had experienced sexual exploitation reduced in 2017 to 2018 compared to the previous year (562 or 5% in 2017 to 2018 and 688 or 6% in 2016 to 2017). However, this proportion varied greatly by gender: over 8 out of 10 sexual exploitation reports were by females (470 female compared to 92 male), accounting for 13% of all females starting treatment and 1% of males. While these figures suggest a difference between genders, Barnardo’s research found that boys tended not to disclose experience of sexual exploitation or abuse as much as girls.

6. Mental health needs

Information on whether a young person starting treatment has a mental health need was introduced into this report for the first time this year. Of all the young people starting treatment in 2017 to 2018, who gave a mental health status, 2,954 (27%) said they had a mental health treatment need. There was a greater proportion of females reporting this than males (37% compared to 22%).

Around 7 out of 10 of young people who reported a mental health treatment need also said that they were currently receiving treatment for their mental health (70% or 2,023). This proportion was broadly similar for males and females (72% of females and 69% of males). Most of the young people that recorded a mental health treatment need were either engaged with community mental health services (57%, or 1,648) or receiving treatment from their GP (9%, or 252).

7. Waiting times and reasons for leaving specialist services

Young people continued to be able to access treatment quickly in 2017 to 2018. The mean waiting time for young people to start their first specialist intervention was around 2 and a half days. Nearly all (97%) of the 16,330 first interventions started by young people had a wait of 3 weeks or under and 77% of first interventions started on the day the young people were referred.

Most (81%) young people who left services in 2017 to 2018 did so in a planned way, no longer requiring specialist treatment interventions. Although this proportion is slightly lower than the previous year (82%), it still suggests that specialist substance misuse services in England are responding well to the needs of young people who access them, and are helping young people to overcome their substance misuse problems.