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What is substance misuse?

Misusing drugs can have serious effects on your mental and physical health, and can harm your wellbeing, education, work and relationships. Substance misuse is more common between the ages of 20–25 years old, and can be a response to personal issues or trauma, or might have started as a way to experiment.

Nicotine (through smoking cigarettes or vaping) and alcohol are the most common substances people use to change how they feel. While both of these can result in addiction, they are legal for adults. Some other ‘legal’ substances (e.g. household products or medicines) can also be dangerous if they are misused. Illegal drugs include cannabis, amphetamines, ecstasy, cocaine and solvents. These substances can all be harmful, for example solvents cause around 50 deaths each year. For more information about the effects and risks of different types of substances, look at the Frank website.

The more you take something, the more likely it is that you will develop a tolerance and need even more to feel the same effects. The danger of becoming hooked increases, and some substances are extremely addictive, such as nicotine or opioid drugs like heroin.

Being addicted to something means you are physically and/or mentally dependent on it. When you’re addicted, instead of enjoying something, you need it to function normally and you can experience withdrawal symptoms if you try to stop. This means it can be hard to suddenly stop taking the substance and the need for it can gradually take over your life.

How is substance misuse related to other mental health conditions?

Children and young people who have problems with substance misuse often experience other mental health conditions and/or social or educational difficulties. Substance misuse can make experiencing poor mental health more likely, and can contribute to physical health problems too.

Cannabis is probably the most commonly used ‘illegal drug’ and research has shown that the earlier you start using cannabis the greater the risk to your mental health. Also, if you are already at risk of developing a mental illness such as depression or schizophrenia (because there is a history of this in your family) then using cannabis will add to your risk of developing an illness like this.

Substance use can also affect your relationships with your family and friends, and lead to problems with education and employment. Taking illegal substances can cause problems with the police and you could get a criminal record. There is also a risk of getting into debt if your substance misuse is out of control or you become involved with dangerous and exploitative groups.

Where can I get help?

If you’re having difficulties with substance misuse, talk to your GP or another professional (for example one of your teachers at school or college) who will be able to help you find support. As a young person, you will often be seen in a specialist service designed for your age group.

For confidential advice you can visit the Frank website.

In most areas there are specialist substance misuse services for young people and often you will be able to refer yourself. These are usually part of or linked to child and adolescent mental health services (CAMHS). If you think you may have another mental health condition (such as depression or anxiety) then you should also talk to your GP or another professional about this and they will be able to help you find support for that too.

You can find more information about mental health referrals here and more information about local mental health services here.

Planning treatment

The type of treatment you’re offered will depend on:

  • how you are using substances
  • how your substance use is affecting you and those around you
  • the reasons for your substance use
  • whether you are experiencing other difficulties (e.g. other mental health conditions or problems at school)
  • your age
  • your family circumstances

The aim of your treatment will be to stop using substances completely and to help you with any other difficulties you are experiencing. Your professional might also want to check your physical health and will help you with any withdrawal symptoms.

You might experience withdrawal symptoms if you have been using opiates (such as heroin), so your professional might suggest an opioid detoxification programme. These can help with stopping gradually and might involve staying in hospital. Benzodiazepines can also cause serious withdrawal symptoms, so if you have been taking these your professional might suggest that you stay in hospital for help with gradual withdrawal.

If you have another mental health condition as well as substance misuse then you might be offered support for this at the same time as support to stop taking substances. You might also have support from children’s social care while you have treatment for substance use if there are concerns about your safety.

To help you stop using substances, you are most likely to be offered:

  • Cognitive behavioural therapy (CBT): CBT works best if you do not have other difficulties in addition to substance misuse and have plenty of support from your family and social network. Research has found that CBT is more effective if your family are involved.
  • Family based treatments (also called multi-component treatments): these treatments are usually offered if you do not have good family or social support and/or you have other difficulties in addition to substance misuse. You might also be offered family based treatments if you are younger and your parents need some extra help to support you better or if you need more support to manage CBT. Some family based treatments involve linking up with other parts of your network such as your school or college.
What about my parents or carers?

Treatment for substance misuse is often more effective if your parents or carers are involved and some types of treatment focus on both you and your family as a whole. Your parents or carers might also need to be involved in there are concerns about your safety.

Your professional should talk to you about how much your parents or carers need to be involved and what information might need to be shared with them. This will depend on your age and ability to make your own decisions about your treatment, and your professional should ask for your agreement about involving your parents or carers. You can find more information about how treatment decisions are made here and more information about confidentiality and privacy here.   

The wellbeing of your parents or carers is important as they may need support and advice themselves. Your professional should help your parents or carers to access any support they need, which could include:

  • emotional support
  • practical support with your care
  • planning in case of emergencies
Transitions between services

Depending on the type of service you are receiving, you might need to move to another service when you are 18. If this is the case then your professional should support you in getting to know the new team and understanding what to expect from them.

You may also transition to another CAMHS service (e.g., if you move house). If this happens, your professional should work with you to make sure that your care can continue smoothly, and that your new service has all the information they need.

For more information about transitioning between services, please see Moving on.

Additional support

The below organisations offer substance misuse specific support for children, young people and their families:

  • AFC Crisis Messenger: a free, confidential, 24/7 text message support service for anyone who is feeling overwhelmed or is struggling to cope. If you need support, you text AFC to 85258
  • Childline: Childline is there to help anyone under 19 in the UK with any issue they’re going through. Whether it’s something big or small, their trained counsellors are there to support you
  • Dan 24/7: organisation offering support to people struggling with alcohol and/or substance misuse in Wales
  • Drugs and Alcohol NI: organisation offering support to people struggling with alcohol and/or substance misuse in Northern Ireland
  • FRANK: website and hotline offering support to people struggling with alcohol and/or substance misuse in England
  • Know the score: website with webchat and helpline for people struggling with alcohol and/or substance misuse in Scotland
  • People Health Agency: organisation offering public health support in Northern Ireland
  • Supportline: charity offering helpline for people of all ages on a wide range of issues including anger, eating disorders, self-harm, depression, anxiety, panic attacks, and addictions
  • The Mix: support and advice for children and young people under 25
  • withyou: organisation offering support to people struggling with alcohol and/or substance misuse across the UK. Website includes webchat support.

Treatments outlined on these webpages may not be available in every local area. It’s important that you discuss with your GP or mental health professional the treatment options available to you. You can also search for services near you on our Youth Wellbeing Directory and find out more about referral processes here.

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