CASUS

Cambridgeshire Child and Adolescent Substance Use Service

Suzanne Hare & Dee Stanford

CASUS delivers:

• Information, advice to young people • Advice and support to parents / carers or someone affected by another

person’s drug or alcohol use.• Training, support and consultancy to professionals working with young

people.• Support for PSHE in schools and alternative education settings.• Sessions for groups of young people at risk and in vulnerable

situations. • Specialist treatment drug and alcohol treatment for young people, which

include psychosocial interventions, family work, harm reduction and

specialist prescribing.

Referral Process• A parent/ carer or professional can refer

• Self referrals

• The young person must consent to referral for treatment. • Phone call 01480 415 278

• CASUS Referral form / letter or CAF ( not via SPA at present)

• Confidential advice and information for parents and carers is available from CASUS .

• www.casus.cpft.nhs.uk casus@cpft.nhs.uk

What is happening in Cambridgeshire?

Health Related Behaviour Survey

Professor Balding, Exeter University

2002- 2012

Little or no mention of NPS

What will 2014 show??

Good News 2011-2012 NTA data tells us…

1) The number of under 18s accessing specialist services for substance misuse in England fell to 20,688 (figure peaked at 24,053 in 2008/2009)

2) The number of young people being treated primarily for class A drugs (such as heroin and cocaine) has fallen by two thirds from 5 years ago

3) Alcohol and Cannabis remain by far the main substances for which under 18s access specialist services in England (92%)

4) NPS. Very small numbers but data capture methods poor.

SUD

No - SUD

10yrs 20 yrs

Experimentation and SUD

Not so good news

• The rise of Poly-pharmacy (“living in the sweet shop...”) – a chemical universe- new substances abound.

- The National Poisons Information Service 2012/13 report notes a 49% increase in telephone enquiries and 128% increase in TOXBASE accesses relating to nps

• Early (< 16 yrs) exposure to (particularly with early positive self-evaluations) drugs such as cannabis -> associated with poorer prognosis, such as adult dependency (Fergusson et al 2003).

• Those young people who do use substances are starting younger, using more, and using stronger varieties

Novel Psychoactive Substances

Legal status: legal, Temporary Class, ABC

Cost: various

Effects: stimulant, depressant, hallucinogen

Risk: poisoning, there is no historic data on effects, they are very difficult to treat

in A&E, symptomatic relief in only, long term effect are mostly unknown

NPS Treatment

•A&E and GPs treat the majority of acute harms arising from NPS•Routine management of intoxication and poisoning evidence of treatment adaption for NPS- “mimic illicit drugs but stronger and potentiated by alcohol etc”

• Challenging to provide information and guidance for those seeking healthcare but wish to continue to use NPS.

“a new substance every 6 days “ “ mxe OTS” AAPG Drug Strategy

Early Findings from UK’s First National Online

Survey of Users of New Psychoactive

Substances (Legal Highs)

• “legal and therefore safe”- main driver for use – “illusion of safety”• belief that health consequences are mild and will not require treatment.• “have I broken the law?”

CASUS Treatment Model

NPS CASUS Treatment

•Primary drug for Rx remains cannabis and alcohol•NPS identified in taking of Drug Hx• Immediate harm reduction messages- Overdose, poisoning, - Hep B - Drug interaction•Psycho-education•Explicit with ‘our concerns’ (heroin, solvents, NPS)•MI to address higher ambivalence•Treatment as usual, including co morbidity

Web: www.casus.cpft.nhs.uk

Youtube: CASUStv

Twitter: casus_cpft

Email: casus@cpft.nhs.uk

Phone: 01480 415278