Drug Education News

The following are recommendations that NICE are consulting on at the moment as part of their work on Community-based interventions to reduce substance misuse among vulnerable and disadvantaged young people. You can see the whole paper here along with a response form and various papers which have informed the development of the guidance and these recommendations.

I would be interested in your thoughts on these recommendations so that we can draw on your comments as the Drug Education Forum builds its response to the consultation.

The deadline for responses to be with NICE is 8 December, so the earlier we have your thoughts the easier it will be to use them in our drafting.

Recommendation 1

Professionals in the NHS, local authorities, education, social care, the voluntary sector and the criminal justice system should identify vulnerable or disadvantaged young people aged over 16 who are misusing substances. They should, as appropriate, refer those misusing cannabis and stimulants for one or more motivational interviews by appropriately trained professionals. Vulnerable or disadvantaged young people who are at an increased risk of misusing substances include those whose parents or other family members misuse drugs, young offenders and those with behavioural or mental health problems. They also include looked after children, those who are homeless, school excludees and truants, and those involved in sex work.

Recommendation 2

Professionals trained in motivational interviewing should provide one or more sessions for young people aged 16 and over who are referred because of their misuse of cannabis or stimulants. These sessions should last about an hour. The interviewer should consider the young person’s use of both legal and illegal substances and encourage them to reflect on any related physical, psychological, social, educational and legal concerns. They should help the young person to consider their options and set goals for reducing or stopping their use of substances.

Recommendation 3

Schools should identify pupils who are vulnerable to substance misuse, as well as those who are already misusing substances, in line with existing Department for Education and Skills guidance. In the case of vulnerable pupils who have behavioural problems, schools should work with behaviour and education support teams (BESTs) and the pupils’ parents. Schools should work with the education welfare service and children’s trusts to ensure that all the pupils identified receive appropriate support at school or through referral to other services. Vulnerable and disadvantaged children and young people who are at an increased risk of misusing substances include those whose parents or other family members misuse drugs. They also include those with behavioural or mental health problems, looked after children, those who are homeless, young offenders, school excludees and truants, and those involved in sex work.

Recommendation 4

Schools should identify vulnerable or disadvantaged adolescents aged under 16 who are at an increased risk of misusing substances. They should refer these adolescents and their families to a structured programme of support. The programme should be led by appropriately trained staff. It should include at least three brief motivational interviews aimed at parents. These sessions should assess the family (including family interaction), provide training in parental skills and encourage parents to monitor their children’s behaviour and academic performance. Some families may need more intensive and ongoing support (for example, family therapy). Vulnerable or disadvantaged children and young people who are at an increased risk of misusing
substances include those whose parents or other family members misuse drugs. They also include those with behavioural or mental health problems, looked after children, those who are homeless, young offenders, school excludees and truants, and those involved in sex work.

Recommendation 5

Professionals trained in behavioural techniques should provide group-based therapy for 10–12 year olds who are referred by schools because of their behavioural problems and vulnerability to substance misuse. The group sessions should last up to an hour and take place once or twice a month, for 1–2 years. They should focus on coping mechanisms such as distraction and relaxation techniques, and developing organisational, study and problem solving skills. They should include goal setting. Parents of these children and young people should receive group-based parental skills training on a monthly basis, over the same time period. The sessions should focus on stress management, communication skills and advice on how to support their child’s development of social-cognitive and problem solving skills. They should include advice on how to set behavioural targets and establish age related rules and expectations for their children.

Recommendation 6

Local authorities, primary care trusts and drug (and alcohol) action teams should produce a demographic profile of vulnerable or disadvantaged under 25 year olds who are at an increased risk of misusing substances. This should be done in conjunction with public health observatories and include information on the factors that make them vulnerable, their age and other locally agreed characteristics. It would be comparable with the kind of data being collected for the common assessment framework (CAF) for children and young people. Vulnerable or disadvantaged children and young people who are at an increased risk of misusing substances include those whose parents or other family members misuse drugs. They also include those with behavioural or mental health problems, looked after children, those who are homeless, young offenders, school excludees and truants, and those involved in sex work.