Young People's Substance Research Articles

The problem of over-medicalisation: How AOD disease models perpetuate inequity for young people with multiple disadvantage.

Young people who experience multiple disadvantage have been identified as some of the most marginalised and under-serviced people in the alcohol and other drug (AOD) system. In this paper, we draw on a range of research evidence to argue that one of the challenges in responding appropriately to the needs of these young people are models of care which seek to ameliorate 'illness' rather than promote wellness. While disease approaches have some important benefits, overly-medicalised AOD treatment responses also have negative impacts. We argue that disease models rest on understandings of substance use as an individual enterprise and thereby pay insufficient attention to the material disadvantage that shape young people's substance use, creating feelings of shame, failure and a reluctance to return to care if they continue to use. Additionally we draw on literature that shows how disease models construe young people's substance use as compulsive, perpetuating deficit views of them as irrational and failing to account for the specific meanings that young people themselves give to their substance use. By focusing on clinical solutions rather than material and relational ones, medicalised treatment responses perpetuate inequity: they benefit young people whose resources and normative values align with the treatments offered by disease models, but are much less helpful to those who are under-resourced,. We suggest that alternative approaches can be found in First Nations models of care and youth programs that attend to social, cultural, and material wellbeing, making living well the focus of treatment rather than illness amelioration.

Improving lives not just saying no to substances: Evaluating outcomes for a young people's substance use team trained in the AMBIT approach.

Adaptive Mentalization Based Integrative Therapy (AMBIT) is a systemic, mentalization based intervention designed for young people with multiple problems including mental health problems. The purpose of this paper is to examine the impact of this approach both on clinical and functional outcomes for young people seen by a specialist young people's substance use service between 2015 and 2018. About 499 cases were seen by the service during this period. Substance use outcomes were obtained for 383 cases using the Treatment Outcome Profile (TOP). Cannabis and alcohol use were the key substance use problems for 81% and 63% respectively. Functional outcomes using the AMBIT Integrative Measure (AIM) were obtained for 100 cases covering domains of daily living, socio-economic context, peer relationships and mental health. At treatment end, cannabis use reduced significantly (t = 10.78; df = 311; p = .00; Cohen's d ES.61 as did alcohol use (t = 6.938; df = 242; p = .000; ES 0.44). Functional improvements were shown in five out of seven domains with highly significant total functional improvements on key problems selected by the client (t = 14.01; df = 99; p = .000; ES1.34). Measuring functional as well as clinical outcomes appears to reflect more accurately the overall benefit of the service to clients.

Pupils learn the risks of drugs and alcohol

Programme aims to reduce young people's substance misuse while giving teachers and parents the skills to identify and tackle problems

Where next with theory and research on how the school environment influences young people's substance use?

Substance use (smoking, drinking and illicit drug use) remains, a serious problem for young people living in industrialised countries. There is increasing interest in interventions to modify the school, environment, addressing the multiple upstream determinants of young, people’s health. This article provides an overview of current theory, about how secondary school environments influence young people’s, substance use before focusing on the Theory of Human Functioning and, School Organisation. It critically examines the extent to which this, theory is substantiated by quantitative and qualitative evidence and, considers how the theory might be elaborated to better inform future, empirical research.

The impact of New Zealand's 2008 prohibition of piperazine-based party pills on young people's substance use: Results of a longitudinal, web-based study

BackgroundThe last decade has seen the emergence of a new phenomenon in recreational substance use with the availability of herbal and synthetic, unregulated, psychoactive drugs in the market place; alongside this, international concern has developed in relation to their use and associated harms. New Zealand (NZ) was one of the first countries to experience this new phenomenon, with products containing chemicals of the piperazine group – mainly benzylpiperazine (BZP) and trifluoromethylphenylpiperazine (TFMPP). In 2008, the NZ Government prohibited these substances, but allowed a 6-month amnesty period for possession. Our study aimed to obtain a measure of change in BZP use over time. MethodsThis study used a longitudinal, web-based survey, with data collected at two time points from the same participants. The first survey was carried out 3 months after BZP prohibition, and included retrospective questions for the 6 months preceding the survey. The second survey was conducted 9 months after prohibition and also included retrospective questions for the 6 months preceding the survey. Results273 sets of paired data were identified. The use of BZP party pills (p<0.0001) and legally available smokeable products (p=0.002) reduced over time. A majority of users of party pills obtained them from friends or from their own stockpiled supplies. The misuse of prescription drugs (p=0.02) increased over time, whereas statistically significant increases in stimulant or alcohol use were not noted. ConclusionFollowing prohibition of piperazine-based party pills, we noted a significant reduction in the proportions of participants using them. The observed increase in the misuse of prescription medicines may relate to their perceived ‘quality’, or as being less ‘illegal’ than illicit drugs.

National-level drug policy and young people's illicit drug use: A multilevel analysis of the European Union

IntroductionRecent research has called upon investigators to exploit cross-national differences to uncover the cultural and structural factors influencing drug use. While the individual-level correlates are well-established, little is known about the association between cross-national variation in drug policies and young people's substance use. This study examines, net of individual-level predictors, the association between national-level drug policy and use of an illicit drug other than cannabis. MethodsThe study uses Eurobarometer repeated cross-sectional surveys in 2002 and 2004 of adolescents aged 15–24 drawn in multistage, random probability samples proportional to population size and density within regions of their country (N=15,191). Participants completed self-reported measures of last month drug use, attitudes toward drugs, school and work participation, and demographics. Gathered from several international bodies, national-level policy measures include drug offense levels, possession decriminalization, and presence and usage of harm reduction strategies. ResultsHierarchical logistic regression models demonstrate that, while controlling for important individual-level predictors, in countries where there is no restriction on possession of drugs for personal use, the odds of drug use in the last month are 79% lower (p<0.05). On the other hand, higher usage of treatment and drug substitution are associated with higher levels of drug use. These results are robust to several alternate specifications. ConclusionsAmong the strongest and most consistent findings, eliminating punishments for possession for personal use is not associated with higher drug use. The results indicate that researchers should take national-level context into account in individual-level studies of drug use.

The provision of a mental health practitioner within a young people's substance misuse clinical team

Evidence suggests that substance misuse service practitioners attempt to work with dual diagnosis patients but lack the skills and knowledge to address both health problems. This study explores the impact of placing a mental health consultant within a substance misuse community team on knowledge, confidence and willingness to work with dual diagnosis patients. A participant action research method was used to explore the role and effect of the mental health consultant on the effectiveness of the practitioners’ work with dual diagnosis patients. The presence of the mental health specialist demonstrated increased confidence, willingness and ability to work effectively with dual diagnosis patients accessing the service. The conditions required for success for this type of service provision is discussed. The accessibility of the consultant via clinical supervision and training impacted on the confidence of the practitioners and increased the level of complexity at which the practitioners were prepared to work ...

Young people's beliefs about the harmfulness of alcohol, cannabis and tobacco for mental disorders: findings from two Australian national youth surveys

Using cross-sectional national survey data, we assessed young peoples' beliefs about the role of alcohol, tobacco and marijuana in the prevention and treatment of mental disorders as well as the predictors of these beliefs. We also compared these findings with those from a similar survey carried out in 2006. Between January and May 2011, a national computer-assisted telephone survey was conducted on a representative sample of Australian youths aged 15-25 years. A total of 3021 young people were presented with a case vignette portraying depression, depression with suicidal thoughts, psychosis, social phobia, depression with alcohol misuse or post-traumatic stress disorder in a young person. Respondents were asked about their beliefs regarding the role of using alcohol, tobacco and marijuana in preventing or dealing with the mental disorders described in the vignettes. Level of psychological distress was assessed by the Kessler 6 scale (K6). More than 75% of respondents agreed that the three substances were harmful for the young people in the vignettes, and that not using marijuana or drinking alcohol in excess is preventive. Males, young adults and more distressed respondents were less likely to endorse these beliefs. No significant changes were observed between surveys. Most young people in Australia are aware of the negative impact of substance use on mental disorders, but a few high-risk groups remain: males, young adults and those with more psychological distress. Future public health campaigns need to target these groups and focus on translating young people's substance use beliefs into behavioural change.

Parents of children at risk—a multi‐agency initiative to address substance misuse amongst parents whose children are at risk of neglect

Child Abuse ReviewVolume 17, Issue 6 p. 454-462 Short Report Parents of children at risk—a multi-agency initiative to address substance misuse amongst parents whose children are at risk of neglect Jo-Anne Welsh, Corresponding Author Jo-Anne Welsh jo-anne.welsh@brightonoasisproject.co.uk Brighton Oasis Project, Brighton, UKBrighton Oasis Project, 11 Richmond Place, Brighton BN2 9NA, UK.Search for more papers by this authorGretchen Precey, Gretchen Precey Independent Social Worker, Brighton, UKSearch for more papers by this authorPauline Lambert, Pauline Lambert Primary Care Trust, Southdowns PCT NHS Trust, Brighton, UKSearch for more papers by this author Jo-Anne Welsh, Corresponding Author Jo-Anne Welsh jo-anne.welsh@brightonoasisproject.co.uk Brighton Oasis Project, Brighton, UKBrighton Oasis Project, 11 Richmond Place, Brighton BN2 9NA, UK.Search for more papers by this authorGretchen Precey, Gretchen Precey Independent Social Worker, Brighton, UKSearch for more papers by this authorPauline Lambert, Pauline Lambert Primary Care Trust, Southdowns PCT NHS Trust, Brighton, UKSearch for more papers by this author First published: 24 November 2008 https://doi.org/10.1002/car.1050Citations: 1AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume17, Issue6Special Issue: Parental and Young People's Substance MisuseNovember/December 2008Pages 454-462 RelatedInformation

Focusing on parental and young people's substance misuse: exploring the links

Focusing on parental and young people's substance misuse: exploring the links

Drug Use Among Homeless Young People in Los Angeles and Melbourne

Purpose To examine the effect of time spent homeless on young people's substance use and use of drug and alcohol services in two countries with contrasting policy and service environments. Methods A crossnational survey was conducted of recently homeless and experienced homeless young people in Melbourne (N = 674) and Los Angeles (N = 620). Questions were asked about alcohol and drug use in the past 3 months, frequency of use, injecting drug use, drug dependency, and perceived need for, and use of, drug and alcohol services. Data were analyzed using logistic regression. Results Substantial numbers of young people reported use of alcohol and drugs. More Australians than Americans and more experienced than newly homeless reported drug use, although there were no differences in frequency of use in the past 3 months. Polydrug use was common, as were injecting drugs and responses that signified drug dependency. All were more common among Australians and experienced homeless young people. A substantial number of young people had “ever” taken part in a drug or alcohol program, but only a minority believed that they needed help from services. Of these, only a minority had sought help. This was particularly so among those who were classified as drug dependent. Reasons for failure to seek help varied. Conclusion Substance use is alarmingly high compared to national samples of young people, especially among those who had been homeless for longer periods. Programs to reduce substance use must take account of the prevailing drug cultures, as well as different subgroups of the population.

A hard habit to break? A role for substance use education in the new millennium

PurposeThe purpose of this paper is to introduce the five papers comprising this special issue on post‐millennium trends in young people's substance use in the UK. The positions taken by the authors of each of the papers in the issue are compared with respect to their conclusions on how best to reduce harmful outcomes for young people in relation to their substance use, and what role exists for health education in this process.Design/methodology/approachThe approach takes the form of a narrative review of the papers in the issue.FindingsAcross substances (alcohol, tobacco and illicit drugs), the authors identify slight downward trends in population prevalence of use by adolescents and young adults since 2000. This downward trend follows some fairly steep rises during the 1990s, resulting in levels of use remaining historically relatively high. The importance of global and demographic changes is identified as being important in understanding the (arguably somewhat limited) scope for changing youthful behaviour. The different recommendations for how to reduce harmful outcomes for young people are discussed: modifying the context/environment of use (for alcohol and tobacco), drugs treatment (for drug‐using offenders), tackling inequality and disadvantage (for heroin and crack cocaine).Practical implicationsTwo key roles for health educators are identified: first, supporting mechanisms already known to be effective in reducing use/harmful use such as smoke‐free environments; second, providing an “expert” source of information used by the vast majority of young people who both want and require this on their lifelong health and drug “journeys”. Health education should have a harm reduction role; measuring success in terms of reducing population prevalence of substance use may be inappropriate and unrealistic.Originality/valueImportant insights are gained into substance use trends by young people when UK trends are set alongside international trends, and when all the psychoactive substances consumed are considered together.

Young Asians and drug use.

It is considered that child health professionals should have sufficient knowledge of patterns of substance (mis)use in young people to enable them to respond appropriately if faced with a client who is, or is suspected of, (mis)using substances. Whilst there is an increasing amount of literature relating to young people's substance misuse in general, there is a paucity of knowledge relating to substance (mis)use amongst young people from an ethnic minority background. In this article the findings of qualitative studies carried out at two sites in Greater Manchester are presented, which suggest that whilst patterns of substance (mis)use amongst Asians may be similar in many ways to those for the general population, they occur within a different cultural context. It is suggested therefore, that there is a need for child health professionals to be culturally sensitive in working with young people who are, or are suspected of, (mis)using drugs - although unfortunately practical examples of such cultural sensitivity have yet to be provided.

Substance Use Among Young People 'Looked After' by Social Services

Young people looked after by social services have been identified as being at increased risk of having, or developing substance misuse problems. Despite such claims, there is a distinct lack of research on the extent and nature of substance use among 'looked after' young people. This paper reviews the published literature on substance use among this population and presents the preliminary findings from a Home Office Drugs Prevention Initiative (DPI) evaluation of a drug prevention intervention among young people living in a residential care establishment. A comparison of these findings with other research data on substance use among young people suggests that 'looked after' young people's substance use is higher than that of the general youth population. Although the substance use was generally recreational and not considered by the young people themselves to be problematic, this level of use, at this life stage, could place them at increased risk of movement into more problematic drug use in ensuing years. The feasibility and implications of implementing drug interventions with this group are also discussed.