Drug Misuse in Children and Young People

Introduction

The use of drugs by children and young people presents both short- and long-term risks to health and wellbeing, with these risks varying by the type of substances taken.¹ Regular use of illicit drugs is not a common feature of most young people’s lives, and for many of those who do use drugs, their use is experimental and ‘recreational’, often waning in early adulthood. However, for some young people their use can become problematic and can lead to long term heavy use.^1,2 Even with low level, occasional use there are health risks associated with adverse reactions, adulterated substances, polydrug use and overdose.

The mental health of young people who take drugs is a particular concern, both in terms of the impact of drug use on an individual’s mental health and of the potential increased use of drugs among those experiencing mental health difficulties.^1,3

As Dame Carol Black’s 2020 'Review of Drugs' highlighted, estimated drug use among those aged 11 to 15 increased by 40% between 2014 and 2018 following a long-term downward trend.⁴ Since 2018, estimated prevalence has reduced, though remains above 2014 levels. The number of young people accessing drug treatment across England has decreased by over 40% since 2009/10. Those who do access treatment may have complex needs, including poor mental health, self-harm, offending and experience of sexual exploitation.^4,5 The review also highlights the increasing risk of young people becoming involved in drug supply and ‘county lines’ networks, further increasing their vulnerability to drug use, violence, exploitation and criminalisation.

Blackpool addresses the substance misuse needs of the population through a range of inter-related strategies and services. In addition to the issues, needs and responses to children and young people's drug misuse outlined below, please also see the following:

• Alcohol use in children and young people
• Tobacco use in children and young people
• Adult drug misuse
• Adult alcohol use

The prevalence of drug use among children and young people

Estimating the prevalence of children and young people’s drug use can be difficult due to a range of factors, from access, confidentiality and safe disclosure, to the comparability of different approaches, reliability of self-reporting surveys and the extent to which surveys are representative. Because of this, prevalence estimates tend to be presented on a national level.

Prevalence is also recorded and reported at various frequencies, often in terms of whether a person has ever used a drug, or used it in the last year or month. The following information is primarily based on reported used of illicit drugs in the last year. Since this can include occasional use, someone trying a substance, and frequent use (e.g. daily or weekly) it should not be considered to be the prevalence level of 'regular use' among children and young people.

Under-16s

The primary source of drug prevalence estimates among under 16s is the biennial schools survey 'Smoking, drinking and drug use among young people in England' conducted by NHS Digital with school pupils in years 7 to 11 (mostly 11 to 15 year olds).

The latest survey was conducted in 2023. It found that overall prevalence of illicit drug continues to reduce from the period prior to COVID-19 (2018) and the last survey in 2021:

• 13% of pupils reported having ever used an illicit substance (down from 18% in 2021). Reported ever use was the same for both males (12%) and females (12%). Reported prevalence of 'ever-use' increases with age, from 6% among 11-year-olds to 23% among 15-year-olds.
• 9% reported using illicit drugs in the last year (12% in 2021), 9% of males and 9% of females. 4% of 11-year-olds reported illicit drug use in the last year compared to 19% of 15-year-olds.
• 5% reported taking drugs in the last month (6% in 2021), the same proportion for males and females. 4% of 11-year-olds (2% in 2021) reported use in the last month compared to 11% of 15-year olds (13% in 2021).
• Cannabis was the most commonly reported illicit substance tried or used, with 7% of all those surveyed having ever taken the drug, the same proportion as in 2021. 3% of 11-15-year-olds report using cannabis within the last month.
• Volatile substance use (glue, gas, aerosols and solvents) was the next common (4.8% ever use, 1.4% in the last month), followed by nitrous oxide (0.5%), followed by 'other drugs' (0.5%) and ecstasy (0.4%) in the last month.*
• Of those who had taken drugs on more than one occasion, 26% of those took drugs on the most recent occasion 'to get high or feel good' (down from 50% in 2021), whilst 17% did so 'to forget my problems' (down from 27% in 2021).
• Pupils who recently smoked, drank alcohol and took drugs were more likely to report low levels of wellbeing / life satisfaction (37%) compared to pupils who had done one of these (31%) and those who have done none (18%).

*The drugs in the survey: ecstasy, cocaine, crack, heroin, LSD, magic mushrooms, methadone, amphetamines, cannabis, ketamine, mephedrone, tranquillisers, poppers, new psychoactive substances, nitrous oxide, and volatile substances (glue, gas, aerosols or solvents). The category 'other drugs' excludes any noted above.  

As figure 1 highlights, prevalence estimates based on this survey show a downward trend in young people's drug use until 2014, when reported use rose sharply. The 2023 survey shows the decline over the Covid-19 period continuing, with proportions now below the 2014 values for all categories of use. 

Figure 1: proportion of young people reporting illicit drug use (ever use, last year and last month), NHS Digital Survey, 2001 to 2023

Drug use of 16 to 24 year olds

For drug use among young adults (aged 20 to 24) please also see our 'drug misuse' page, which provides additional information around the prevalence estimates from the Crime Survey for England and Wales 2024 (CSEW).

For those aged 16 to 19, the 2024 CSEW found that the proportion of those reportedly using an illicit drug in the last year is now at its lowest rate (figure 2). For those aged 20 to 24 In 2023/24:

• 15.4% of 16 to 19 year olds had used ‘any drug’ in the last year (16.6% in 2022/23) and 17.3% for those 20-24
• Cannabis was the most frequently used drug in the last year for those aged 16-19 (13.4%) and 20-24 (14.1%)
• The proportion of young people aged 16 to 24 reporting use of any illicit substance in the last month was 7.3%, down from 10.0% in 2022/23
• Of those reporting use in the last month, cannabis was the most widely used drug (6.2% of those 16-24), followed by ketamine (1.3%), any cocaine (1%) and powder cocaine (1%)

Figure 2: trend in those aged 16-24 reporting use of any illicit drug in the last year - CSEW 2001/02 to 2023/24

Figure 3: CSEW proportion using drug in last year, by substance for ages 16 to 19 and 20 to 24, England and Wales, 2001/02 to 2023/24

Children and young people's reported drug use in Blackpool

Drug use prevalence estimates from either the NHS Digital survey or the CSEW are not available for young people at a local level. Whilst not able to generate a Blackpool-wide prevalence estimate, the biennial survey 'Supporting the Health and Wellbeing of Young People of Blackpool' from 2024:

• 13% of pupils surveyed in Years 8 to 10 (aged 12 to 15) had ever used illicit drugs. 6% reported use within the last month
• 16% of Year 10 pupils reported having used cannabis
• 31% of Year 10 pupils reported having been offered cannabis, compared to 34% in 2022
• 4% of pupils (12 to 15) have used drugs and alcohol on the same occasion, with 1% using more than one type of drug on the same occasion
• 14% of Year 12 (aged 16-17) have ever used illicit drugs, with 4% saying they have used a drug within the last month
• 14% of Year 12 have used cannabis
• 41% of Year 12 students have been offered cannabis, 8% have been offered new psychoactive substances

Drug-related harms and risk groups

Some children and young people may use substances as a way of dealing with ongoing negative feelings and experiences, or the social and emotional impacts of childhood adversity or trauma.² Because of these factors, young people using substances, particularly those accessing specialist services, may be more likely to have wider issues and challenges that can affect or be associated with their substance use and any supportive response to their needs. These include:

• 48% of young people accessing treatment across England in 2024/25 said they needed mental health treatment
• 48% of females and 16% of males reported self-harm 
• 9% of females and 1% of males reported sexual exploitation
• 10% of males and 5% of females reported criminal exploitation
• 18% reported being affected by domestic abuse
• 11% being in care / a 'looked after child', a child in need (12%) or having a child exploitation plan (8%) are also vulnerabilities
• almost twice as many males as females entering treatment were recorded as not being in employment, education or training⁵

Young people who experience these 'vulnerabilities' may also be more likely to engage in polydrug use, using multiple substances at the same time or sequentially within a specific time. Polydrug use can lead to increased health risks, including in some cases overdose (see JSNA Adult Substance Misuse section). 62% of females and 49% of males accessing treatment nationally in 2020/21 reported polydrug use.

Hospital admissions

In the period 2021/22 to 2023/24, 35 young people aged 15-24 in Blackpool were admitted to hopsital due to substance misuse, and the rate of hospital admissions was 76.9 per 100,000 (directly standardarised rate). While this is still significantly higher than the England average rate of 47.4 per 100,000, rates in Blackpool have been declining since 2013/14-15/16, when 174 young people were admitted to hospital and the rate was 344 per 100,000, the highest in the country (Figure 4).

Figure 4: Hospital Admissions Due to Substance Misuse (15 to 24 years), Blackpool, North West and England, 2008/09-10/11 to 2021/22-23/24

National hospital admission statistics suggest that there may also be aged-based variation in admissions. Hospital admission statistics from NHS England on hospital admissions for drug-related mental and behavioural disorders show a younger age profile than those for poisoning by drug misuse, apart from in the under 16 age group where admissions are higher for poisoning by drug misuse. Levels were highest for younger people (apart from those under 16), peaking between ages 25 and 34.⁶

Looked After Children and Children in Need

Blackpool has the highest rate of looked after children in England. 2023 data from the Department for Education shows that 10.9% of 'Children in Need' episodes identified drug misuse by the child as a factor identifed at assessment. This compares to 4.9% of children across England.  A fifth (20.7%) of children in need episodes identified drug misuse by a parent as a factor at assessment compared to 13.2% across England.⁷

School Exclusions and Suspensions

In the 2019/20 academic year approximately 40 school suspensions in Blackpool were related to drugs and alcohol. This represents 3% of overall suspensions, the same as the national rate for suspensions related to alcohol and drugs. This proportion has been similar over the last six years, both nationally and locally.

Drug Treatment for Children and Young People

Information about drug treatment services is compiled nationally by the National Drug Treatment Monitoring System (NDTMS). Regularly updated national and local drug treatment service data can be found at the NDTMS website.

Specialist drug treatment services for young people tend to be separate from adult services because young people's drug and alcohol issues and concerns tend to be different from adults', and the response needs to adopt a child-centred approach that considers the age and maturing of the person, acting on safeguarding issues where relevant. In Blackpool, support and treatment for children and young people aged 10 to 24 years old is provided by the Blackpool Adolescent Service.

Across England in 2023/24 there were 18,402 young people aged 18-24-years in adult treatment services. In young people's drug and alcohol misuse services there were 14,352 under the age of 18.  Numbers of young people (under-18) attending specialist substance misuse services for both alcohol and drug treatment have increased from the previous year (12,418), although this figure has reduced from a peak of 24,165 in 2009/10.

This is due to a number of factors, including reduced funding for substance misuse treatment services, and generally reducing drug prevalence among children and young people in the early 2000s. 

The number of under-18s in drug and alcohol treatment across England in 2023/24 has returned to similar numbers when compared with the pre-COVID 2019/20 period. Like other services, young people's substance misuse services were affected by the pandemic, particularly during its early stages and national lockdown periods. Most services had to restrict face-to-face contacts which affected the types of interventions provided. The impact on other services, particularly education and youth justice provision, also resulted in fewer referrals for treatment over this period.

In Blackpool in 2023/24 there were 196 young people under 25 in drug and alcohol treatment services.⁸ Of these 83 (42%) were under 18 and 113 (58%) were 18 to 24-years. The number of under-18s in drug and alcohol treatment declined between 2009/10 and 2018/19, before increasing over the last five years. Numbers of 18 to 24-year-olds in treatment have increased since a low of 64 in 2017/18 (figure 5). There are a number of reasons for these patterns, some of which reflect national trends:

• Reductions in funding around school outreach and early intervention provision from 2009/10, resulting in fewer young people presenting with substance misuse concerns
• Declining numbers of alcohol presentations (and prevalence), locally and nationally
• A focus on trauma-informed services in recent years increasing the identification of and response to substance misuse in both under-18 and young adult services (social care, youth justice, leaving care services)
• Recent increase in multi-agency and improved referrals and joint responses

Figure 5: numbers of young people in drug and alcohol treatment, Blackpool 2009/10 to 2023/24

 

Drug services record the primary substance of concern for those entering treatment, together with additional or secondary substances of concern. In 2023/24, the primary substance of concern for under-18s in the Blackpool treatment service was cannabis (45%). Alcohol accounted for 18% of young people in treatment, 7% for ketamine, and 7% for cocaine use.

The sex profile of those in treatment also varies according to age group, with males accounting for 60% of the under-18s in treatment, compared to 71% of those aged 18 to 24 (2023/24) (figure 6). Nationally in 2023/24, 62% of under-18s and 61% of 18 to 24 year olds in treatment were male.

Figure 6: sex profile of young people in treatment, Blackpool, 2023/24

NDTMS data for 2023/24 also shows that, for under-18s in treatment:⁹

• 52% were referred via Children and Family Services compared to 23% nationally. This is at least in part due to the integrated nature of Blackpool Adolescent Service.
• 9% were referred from education services, compared to 32% nationally.
• 24% were in mainstream education, and 29% were in alternative education (compared to 62% and 165 nationally)
• 77% were living with parents (87% nationally).
• 5% were identified as ‘children in need’ (compared to 6% nationally).
• 45% started treatment aged under-16 (early onset), lower than the national rate of 56%.
• 17% identified as tobacco smokers at the start of treatment, compared to 9% nationally.
• 87% (of those under-25 years, not under-18) reported having consumed alcohol in the 28 days prior to commencing treatment (90% nationally).
• 27% were identified as having a mental health treatment need at the start of treatment, compared to 52% nationally.
• 80% successfully completed treatment, compared to 85% nationally. 

National and Local Strategy and Response

In 2021 the UK Government released From Harm to Hope: A 10-year drugs plan to cut crime and save lives (see also JSNA Adult Drug Misuse section). Within the strategy the government identified:

• increased treatment capacity
• the importance of school-based prevention and early intervention
• increased support for young people and families most at risk of substance misuse (including funding for the Supporting Families Programmes, expanded provision for looked after children, healthcare support in the secure estate, and increased access to mental health provision)

The national strategy is underpinned by strong local Combating Drugs Partnerships to reduce drug-related crime, harm, overall use, supply, and to increase engagement in treatment and improve long-term recovery. By the end of 2022 partnerships are expected to have a local drug strategy and delivery plan. Partners across Blackpool are working towards this, building on existing partnerships already formed through Project ADDER (and Young ADDER) and other local initiatives.

 [1] Advisory Council on the Misuse of Drugs (ACMD) (2006) Pathways to Problems: Hazardous use of tobacco, alcohol and other drugs by young people in the UK and its implications for policy. 

[2] Aynsley, A., Buchanan, L., Burrows, N. & Bush, M. (2017) Childhood adversity, substance misuse and young people’s mental health. Addaction / Young Minds. 

[3] Royal College of Paediatrics and Child Health (2020) State of Child Health: Alcohol and drug use in children and young people. 

[4] Dame Carol Black (2020) Review of Drugs: Executive Summary. 

[5] Office for Health Improvement & Disparities (OHID) (2022) Young people's substance misuse treatment statistics 2020 to 2021: report.

[6] NHS England, Statistics on Public Health, 2023, Drug misuse related hospital admissions

[7] Department for Education (2024) Children in Need: 2023 to 2024 

[8] National Drug Treatment Monitoring System. Data presented for the Blackpool Adolescent Service includes all young people receiving treatment within the service. This may include a very small number of young people who live outside the Blackpool area, and similarly excludes a small number who may be resident in Blackpool but receive treatment elsewhere (e.g. in the secure estate or with another provider). It also excludes anyone under 25 who may be registered with adult treatment services.

[9] National Drug Treatment Monitoring System (NDTMS). This data is restricted and no further information is provided in order to avoid deductive disclosure.