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Helping children say no to drugs

The National Institute for Health and Clinical Excellence (NICE) has issued new national standards calling for anyone who works with young people to identify those who are vulnerable to drug problems, and intervene at the earliest opportunity - before they start using drugs at all or before they get into worse problems if they are already misusing drugs.

The guidance gives advice on stepping in and helping young people access the right support and services, and outlines effective individual, family and group-based support that can improve motivation, family interaction and parenting skills.

Professor Mike Kelly, Director of the Centre for Public Health Excellence at NICE explains: "In England and Wales in 2003/04, class A drug use was estimated to cost around £15.4bn in economic and social terms. It is in all of our interests to tackle this problem at the earliest opportunity so that we can prevent the problem from getting any worse."

Vulnerable young people such as those excluded from school, those who have been in care, those whose parents misuse drugs and serious or frequent offenders are on average five times more likely to use illegal drugs than their peers, and there are currently over 70,000 problematic drug users in England between the ages of 15 and 24.

Professor Peter Littlejohns, Clinical and Public Health Director at NICE and Executive Lead for this guidance says: "Young people aged between 16 and 24 years show the highest prevalence of illicit drugs use in the UK, with over 45% having used one or more illicit drugs in their lifetime. Some of these young people will not develop a serious problem; however, 24% of vulnerable young people reported using illicit drugs frequently in the last year, compared with 5% of their less vulnerable peers.

"This guidance will help practitioners working with young people, to understand which interventions are effective and how they should be used with those at high risk of substance misuse."

Dr Catherine Law of the UCL Institute of Child Health and Chair of the Public Health Interventions Advisory Committee at NICE welcomed the new guidance: "The good thing about these recommendations is that they can be implemented by any individual whose role involves interacting with young people in their daily work. We are not just looking to healthcare professionals and teachers to spot those who are vulnerable to substance misuse and take action. This guidance can be used by anyone who works in a community setting - for example a youth worker at the local drop-in centre or a probation officer."

But the interventions suggested are not meant to be a "quick-fix" solution, points out Professor Mark Bellis, Director of the Centre for Public Health, Liverpool John Moores University. "They involve working with vulnerable individuals and their families over the long-term to address other needs such as problem solving, relaxation and study skills.

"However, as they are based on the best available evidence, we know that interventions which involve working with families and young people in the long term should have lifelong benefits and will work in many cases."

The guidance is available at