Prevention: time to look at the bigger picture?

DrugScope’s new Director of Policy, Influence and Engagement, Andrew Brown, writes his inaugural blog for us on a subject close to his heart…

I’m now in my third week at DrugScope and I’ve already learnt a huge amount about the work we’re doing and how it connects to other, wider agendas. 

For example, I’ve been hugely impressed by the high quality of the work that we and our colleagues in the MEAM coalition have been doing to improve outcomes for some of the most vulnerable and troubled adults in our communities.  We will shortly take that further through the Voices from the Frontline project which will be – as the name suggests – trying to make sure that the views of service users and those who are working with them are part of policy consideration at national and local levels.

But for this, my first blog for DrugScope, I want to concentrate on an area that has been at the centre of my professional life for the last decade; how do we improve the quality of drug and alcohol prevention for young people through our school system.

Like my fellow members of the European Society for Prevention Research I’m conscious that while school-based prevention can be effective, it often hasn’t been and we have to be conscious that some approaches have been shown to do more harm than good.

As the Education Select Committee start their investigation into Personal, Social, Health and Economic (PSHE) education in schools, there’s an opportunity to reiterate the need for our health education to take account of where evidence is leading us, and to improve the experience that young people get.

My view is that much as in recovery, there’s an increasing recognition that we should be looking to the wider lives of young people and address substance use as part of the complexity of their lives.  That’s why I welcome the recent editorial in the BMJ pointing out that it isn’t a zero sum game when it comes to health education and wider academic attainment.

And interestingly a number of approaches that seem very promising look at the deeper roots that lead to young people developing problems and work from there.  One programme, which is widely acknowledged as having strong evidence, is the Good Behaviour Game, a strategy for teachers to use in primary schools; developed in the US and which will be the subject of the first UK randomised control trial next year.

I have great hopes for the programme, but we know that it takes a long time for evidence to accumulate and for programmes to become adopted in mainstream practice.  In the meantime, there is clear guidance that every school and teacher can take which will improve the quality of the experience of pupils.

I hope that many DrugScope members and supporters will join us in calling on the Education Select Committee to add their voice to the earlier recommendation by the Home Affairs committee, and to those of young people going to school now, that PSHE should be an statutory part of the school curriculum.

The deadline for doing so is 12:30 on 6 June.

If the cap fits…

Senior Policy Officer Paul Anders takes a closer look at the welfare cap and what it means in practice.

The Government’s 2014 Budget introduced a new social security or welfare cap as part of efforts to reduce a social security budget that the Government regularly describes as having got out of control. This has received significant media coverage and I thought it might be worthwhile looking at the consequences of the new cap and how it sits in relation to two other recently introduced caps.

The first of these affected Local Housing Allowance (LHA).  It is part of a number of measures designed to bring down the overall cost of LHA, including uprating LHA amounts by the consumer price index measure of inflation (with a fixed increase of 1% this year and next), moving to the 30^th percentile from the median and introducing an absolute limit of 4 bedrooms regardless of household size and composition. A further change was extending the shared accommodation rate to those aged up to 35, with some exceptions – some of which may apply to people in treatment, if they have, for example, lived in some types of residential services for 3 months or longer.

The second cap to be introduced was the overall benefit cap. This limits claimant household income to the ostensible median wage for comparable working households - £500 per week for couples and single parents with children, and £350 per week for single people without children living with them. The extent to which claimant households are affected by either of these caps depends on a range of variables, but they will primarily tend to apply to larger households and those living in expensive areas such as London and the South East – almost half of the 38,665 households capped to the end of January 2014 were in London.

The 2014 budget introduced a different kind of cap – instead of being targeted at individuals or households to address instances of extremely large claims, the welfare cap is meant to act as a limit to most spending on social security. The cap has been set according to Office of Budget Responsibility (OBR) projections, starting at £119.5bn in 2015-16 and rising to £126.7bn in 2018-19, with a +2% margin. This is out of total social security spending of around £200bn (and total government spending of £720bn, by way of context), this discrepancy being the result of some types of benefit being excluded from the cap:

Included

Attendance Allowance, bereavement benefits, Carer’s Allowance, Christmas Bonus, Disability Living Allowance, Employment and Support Allowance, Financial Assistance Scheme, HB (except HB for JSA claimants), Incapacity Benefit, Income Support, industrial injuries benefits, In Work Credit, Maternity Allowance, Pension Credit, Personal Independence Payment, Return to Work Credit, Severe Disablement Allowance, Social Fund – Cold Weather Payments, Statutory Adoption Pay, Statutory Maternity and Paternity Pay, Universal Credit (except for jobseekers), Winter Fuel Payments, Personal Tax Credits, Child Benefit, Tax-Free Childcare

Excluded

Jobseeker’s Allowance and HB for JSA claimants, Universal Credit for claimants subject to full conditionality and on zero income (i.e. most people currently on JSA), State Pension (basic and additional), transfers (e.g. TV licences for over-75s), benefits paid from DEL (e.g. Funeral Expense Payments, Sure Start Maternity Grants and New Enterprise Allowance)

There was a Commons vote on the cap which attracted cross-party support. The reason? The Government claimed that ‘cyclical’ benefits like Jobseeker’s Allowance (JSA) and housing support for unemployed people had been excluded, meaning that the cap wouldn’t impact on individuals or households affected by a future economic downturn. This resulted in the cross-party support, even though it’s not strictly true: Tax Credits and housing benefit for working claimants are directly influenced by the economy and job market, as is the number of Employment and Support Allowance (ESA) claimants. The same goes for their counterparts under Universal Credit.

What does the cap mean in practice?

It’s important to reassure clients that the cap doesn’t mean that there’s any new limit on individual benefits. Should the OBR indicate that the cap is likely to be breached, the government has to table a motion in the House of Commons:

·         Proposing to increase the cap; or

·         Explaining why spending above the cap is necessary; or

·         Proposing changes to bring spending back beneath the cap.

It’s not clear yet what would happen in the event of the government losing the vote, but we do know that there’s nothing to say that any cuts to bring spending back under the cap would have to come from the particular benefit(s) that have been responsible for breaching it in the first place. It wouldn’t necessarily follow that further increases in the cost of housing support for people in employment (a not unlikely scenario – most new Housing Benefit claims in 2010 and 2011 were made by people in employment) would result in further LHA/HB reductions, although any shortfall would need to come from one or more of the benefits subject to the cap.

Out of control?

A final word about the claim that spending on benefits has got out of control. Given the number of households who are entitled to some sort of social security and changes to the system over time, it’s arguably possible to find figures that support almost any position.

What is pretty clear is that as a percentage of Gross Domestic Product (GDP), spending on benefits (including pensions) has increased. Much of that increase is due to positive reasons (increased life expectancy and sick or disabled people living longer, more active lives than was the case a few decades ago), but there are more negative reasons too. Spending on Housing Benefit for unemployed and employed people has increased, to an extent as a consequence of a reduced stock of social housing and long-term structural problems in the UK housing market, and the cost of Tax Credits and Housing Benefit for employed households reflects a tendency towards low wage employment.

Turning to benefits at an individual level on the other hand, the values of most main benefits have tended to decline compared to average earnings, whether under Conservative, Labour or coalition governments. ESA has declined from around 15.5% of average earnings in in 1995 to around 13% in 2008, before recovering to about 14.5% in 2012. By the same measure, JSA has declined from around 23% in the early 1970s to around 12% in 2012, or, to put it another way, while JSA has almost kept pace with the Retail Price Index measure of inflation, if it had kept pace with average earnings, it would now be worth around £145 instead of £72.40.

Also at an individual level, the Council of Europe’s European Committee of Social Rights suggested in a 2013 report that some individual types of benefits in the UK were too low, although it should be noted that all of the 37 countries reported on were also found to be in breach of European Social Charter requirements, and some to a greater extent. Returning to the macro level, Ha-Joon Chang, a professor of economics at the University of Cambridge, argued in a recent Guardian article that compared to the UK’s OECD peer group, spending on social security as a percentage of GDP is unexceptional. Data from Eurostat suggest that compared to western European peers, welfare spending in the UK may be somewhat lower than the norm. (Incidentally, Eurostat data also suggest that UK spending on employment support and labour market policy interventions is also rather low, even while we have a comparatively demanding conditionality regime – although that is a blog for another day).

It’s complicated

Whether or not the welfare bill is out of control or unaffordable and what the likely impact of spending on social security may be is a question for politicians and other policy makers, as well as macro and behavioural economists. There is evidence that while what we spend on welfare has increased by some measures, it remains unexceptional compared to other countries, and that at an individual claimant level, benefits do not appear particularly generous.

That may seem like fudging the issue, but the reality is, social security is complex, and it’s worth bearing that in mind when sweeping statements are made.

The draft Child Poverty Strategy 2014 – 17: share your views with DrugScope

Last month, the Government published its draft Child Poverty Strategy 2014-17.  Here, Senior Policy Officer Paul Anders sets the scene – and invites your feedback to DrugScope’s response.

Child poverty concerns drug and/or alcohol treatment providers for a number of reasons. Many services work with families affected by substance use, with local authorities as part of Troubled Families provision, or work directly with young people themselves. Most services will be aware of the sustained harm a deprived childhood can often cause and will have an interest in mitigating it.

The current measures of child poverty are contained in the Child Poverty Act 2010:

• Relative income: household income less than 60 per cent of current median income;
• Combined low income and material deprivation: children who experience material deprivation and live in households with incomes less than 70 per cent of current median income;
•  Absolute income: household income less than 60 per cent of 2010/11 median income adjusted for prices; and,
• Persistent poverty: household income less than 60 per cent of current median income for at least three out of the previous four years.

In November 2012 the Government launched a consultation on additional or alternative ways to measure child poverty. They proposed a new ‘multidimensional’ measure which could potentially include a range of other factors, such as worklessness, poor housing, parental skill and parental drug and/or alcohol use. The rationale included the need to learn more about ‘what it means to grow up experiencing deep disadvantage’ and the need to think more about the causes and routes out of poverty.

We were concerned that the proposals appeared to conflate or at least misrepresent the complex relationships between cause, effect and correlation.  In particular, they appeared to draw a connection between parental drug and alcohol use and child poverty – ignoring the lack of evidence as to the direction of any causal relationship between poverty and substance use.  Instead, government communications emphasised a small public opinion poll conducted on behalf of the Department for Work and Pensions, suggesting that respondents thought that drug or alcohol dependency was more important than income in deciding whether a child was growing up in poverty. 

A further concern was that claiming such a link between parental drug and/or alcohol use and child poverty risked further stigmatising parents with histories of substance use and, for that matter, households living in poverty more generally. Any solution to child poverty will require socially inclusive policies focused on reintegration.  If drug and alcohol use is disproportionally (and potentially incorrectly) emphasised as a causal factor of child poverty, the public, services, employers and other stakeholders are even less likely to be receptive to the reintegration of people with experience of substance use.

Given our shared concerns, Adfam, Alcohol Concern and DrugScope submitted a joint response to the consultation; I blogged about it at the time. The idea of a multidimensional measure – or indeed a series of them – was in many respects very appealing, but we felt that anything that blurred the current focus on income and material deprivation risked not so much moving the goalposts as burying them.

In March 2014, the Government published its draft Child Poverty Strategy, including a summary of responses to the 2012 consultation. There was support for a multidimensional measure, but as was the case with DrugScope and partners, most respondents emphasised the overriding role that income and material deprivation must have in any definition of poverty. For the time being, the measures in the Child Poverty Act 2010 apply.

About the draft Child Poverty Strategy 2014-17

The draft Strategy contains proposals to reduce child poverty grouped under the following headings:

·         Supporting families into work and increasing their earnings;

·         Improving living standards; and

·         Preventing poor children becoming poor adults through raising their educational attainment.

Under these headings, many of the individual proposals are things already in place, like the Work Programme (including the two drug and alcohol pilots, which are to be continued), the Troubled Families initiative and drug/alcohol payment by results pilots, or on the slipway, like Universal Credit (including ‘tailored conditionality’) and free school meals.

The proposals also include ‘investing in drug and alcohol treatment’, although this appears to reflect only the process of localism and public health reform that started in April 2013, the draft Strategy stating that local authorities will have ‘more freedoms and funding to local areas to enable those who know their communities best to decide which services to offer’.

DrugScope/LDAN will, jointly with Adfam, be submitting a response to the draft Child Poverty Strategy. If you would like to feed in to this, you can do so by taking a short survey here: 

https://www.surveymonkey.com/s/Draft_Child_Poverty_Strategy .

Alternatively, please get in touch with Paul Anders at paul.anders@drugscope.org.uk

DrugScope launches new briefing on older people’s substance misuse on behalf of the Recovery Partnership

Gemma Lousley, DrugScope’s Policy and Engagement Officer, reports back from the launch event

At the end of February, DrugScope launched It’s about time: Tackling substance misuse in older people, a new briefing published on behalf of the Recovery Partnership. The launch event took place at the Guildhall, in London, with around 50 attendees from substance misuse and older people’s services, as well as commissioners and policy makers.

Several key issues were raised at the event. Marcus Roberts, DrugScope’s Chief Executive, noted that there is a growing awareness of substance misuse as a significant issue for older people, which the report aims to develop. Nevertheless, many of the specialist services visited during the research process for the briefing face funding problems; the majority don’t receive ‘mainstream’ drug and alcohol money, but are supported by independent funders, with fixed-term financing. Sustainable funding needs to be found so that these services can develop their expertise and provision, and to enable them to have a lasting impact.

Following a comprehensive presentation from Dr Sarah Wadd on the scale and nature of substance misuse among older people, Karen Black from Bristol Drugs Project (BDP), which runs the ‘50 Plus Crowd’ – one of the projects featured in the briefing – picked up on the importance of sustainable funding as she highlighted the levels of demand now being placed on the service. She explained that socially-oriented provision, including activities and groups, has played a key role in drawing older people into the service, but noted that many service users now need a higher level of ongoing support, including one-to-one keywork.

She also explained that the outcomes the service works to are not focused on ‘successful completions’ and recovery, but on improved levels of health and wellbeing. In the new ‘public health’ landscape, this should have a particular resonance, and is an opportunity to be built upon with commissioners and decision makers.

Focusing on the loneliness and isolation that some older people experience, which can be an underlying cause of substance misuse, Emma Spragg and Pam Creaven from Age UK noted that there can be a level of acceptance around this among both statutory and voluntary services – a belief that ‘nothing can be done’. While challenging this, they pointed, too, to the particular difficulties of addressing social isolation among older people in the current climate of austerity, when services in the community such as day centres are rapidly disappearing.

Emma and Pam also highlighted that the commissioning of domiciliary care for older people needs to be rethought: if carers are working to fifteen-minute appointments, how will they be able to identify substance misuse issues among those they are working with, and provide support around this?  

Finally, Mike Kelleher from Public Health England (PHE) noted that the report coincides with a number of PHE’s key priorities nationally, including addressing dementia, and reducing preventable deaths and ill health associated with alcohol misuse and smoking. He also highlighted that, while we are now in the era of localism, PHE can support the development of this agenda through national guidance and frameworks, and PHE regional centres have a key role to play in supporting commissioning and so the development of services.

There is a real momentum around this issue at the moment, and DrugScope will be working to ensure that real gains are made. After all, it’s about time.

For more information about the report, please contact Gemma Lousley, Policy and Engagement Officer, at gemmal@drugscope.org.uk

Joining the dots: homelessness, substance use and lessons for future commissioning

At the end of January, Crisis and the Joseph Rowntree Foundation formally launched their Homelessness Monitor England 2013 report. This research, carried out by leading academics in the field of housing and homelessness, looks at the impact of a range of economic and policy developments on homelessness. This includes the post-2007 economic downturn and housing market, the impact of welfare reform and reduced public sector spending, and more generally, other government policies that might have implications, such as the localism agenda.

The research has been funded from 2011 to 2015 and covers (separately) Great Britain, England, Scotland, Wales and, from 2014, Northern Ireland. The research focusses on the numbers rough sleeping, single homeless people, statutory homeless households and the hidden homeless, such as ‘sofa surfers’ and people living in crowded or insecure housing.

While the causal relationships are complex, the connection between substance use and homelessness or housing need is clear. 28% of rough sleepers contacted in London in 2013 had support needs relating to drugs, while 41% had needs relating to alcohol. From the treatment sector’s perspective, in DrugScope’s State of the Sector 2013 research, housing and housing support was identified as the support need most often presented, the most common local gap in provision and also as an area of support where availability appears to have deteriorated over the previous 12 months. As a key component of recovery capital, this may pose some challenges.

Another relevant factor is the removal of the Supporting People (SP) ring fence in 2009. While this has not been without implications for drug and alcohol services and their clients, the impact on homelessness services has been more marked, with some evidence of substantial localised disinvestment. However, while there are similarities, the current position, for community drug and alcohol services at least, is not quite analogous. The funding formerly provided within the Pooled Treatment Budget has been rolled into the broader Public Health Allocations, the latter being ring fenced for public health purposes until at least 2014-15, but there is at least the risk that greater discretion around funding and commissioning could have similar effects on drug and alcohol services.

The last speaker at the Crisis Homelessness Monitor launch was Paul Downie, Deputy Director of Homelessness and Support at the Department for Communities and Local Government, who argued that while financial pressures faced by local authorities are real, outcomes and services can be maintained (or improved) at the same time as making savings through intelligent commissioning, joined-up service design and breaking out of silos.

As one of the four partners in the MEAM Coalition, DrugScope believes that joined-up commissioning and services can improve outcomes for people with multiple needs and also offer value for money. It remains to be seen, however, whether there is sufficient scope to commission intelligently and align and sequence interventions in such a way that outcomes can be protected in the face of such significant pressure on local authority budgets.

One concern is that if breaking out of silos and aligning services was especially easy, more progress would have been made by now – the suggestion itself is not novel. Where there may be grounds for optimism is in the Community Budget concept, which builds on some of the learning from previous initiatives including the previous government’s Total Place. Four areas took part in the Whole-Place Community Budget Pilots from 2012. Last year, the government announced that nine additional areas will receive support via the Public Service Transformation Network to incorporate some of the lessons from the pilots.

Drug and alcohol treatment hasn’t itself been a specific priority for the four pilot areas, which focussed on domestic violence, health and social care, work and skills, the Troubled Families agenda, children and young people, reoffending and making better use of local authority assets. The importance of addressing substance use has, however, been highlighted at almost every step and the Community Budget model suggests at least the potential to positively transform local public service delivery.

The Community Budget model is above all intended to be owned and designed locally.  Its principles broadly include bringing together local government, central government agencies and others with the aim of pooling resources and commissioning coherent and proactive services that are more focussed on long-term outcomes and the individual, rather than on process. Evaluations of the first four pilots have been positive, and the National Audit Office was broadly supportive in its report. The Local Government Association commissioned Ernst and Young to review the potential savings, which they estimated at between £9.4bn and £20.6bn over 5 years.

The Communities and Local Government Committee reported in October 2013 that Community Budgets have the ‘clear potential to facilitate cheaper and more integrated public services. They can also be used to make public services more effective by focusing on the specific needs of local areas and individual service users. However, achieving their full potential will require strong leadership at a local level as well as a commitment from central government to facilitate local partnerships and the flexibilities needed to develop local strategies and solutions to specific local issues’.

With all this, realism is needed. Ultimately, local authorities will need to spend less and commission fewer and / or smaller services.  However, the Community Budget approach does at least give cause for optimism that this can be done - while protecting the interests of the people who use them.

DrugScope provides the London Councils-funded PLUS (pan-London umbrella support) for organisations working around homelessness in London, in partnership with Homeless Link and Shelter. Please contact Paul Anders for information.

A New Year’s message from Marcus Roberts, DrugScope’s new Chief Executive

'For last year's words belong to last year's language

And next year's words await another voice' T S Eliot

2014 promises to be another big year - for DrugScope, our members, our partners and 'the sector'. A lot of the new bodies and systems will be celebrating their first birthdays in a few months, with an expectation that this could make them more assertive in setting their priorities and allocating their spending from April 2014. Local authorities will face some tough decisions with their budgets subject to further cuts this year. There is also a huge agenda of change for the welfare and criminal justice systems – not least, the Ministry of Justice’s Transforming  Rehabilitation initiative that will potentially have significant implications for offenders with drug and alcohol problems.

We need to redouble our efforts to provide compelling and relevant answers to the question 'Why Invest?' at local level, engaging with non-specialist commissioners and elected officials, and speaking to local concerns and priorities. Fortunately, we've got the data, connections, profile, stories and some good resources too. DrugScope is developing and collecting these resources as part of its work on behalf of the Recovery Partnership.

Nationally, we need to monitor developments and share experiences, to capture good practice and examples of adaption and resilience, while also providing early warning of any threats to drug and alcohol services that could jeopardise the ambition to 'build recovery in communities' that is the centrepiece of the national Drug Strategy. For example, DrugScope will be publishing our 'State of the Sector' report later this month.

The question 'how invest?' is related and just as important - this is partly about the quality of commissioning processes, and the development of things like payment by results, personalisation, strategic recovery champions and Whole Place Community Budgets. But it's also about building on a legacy of evidence based practice, improved clinical governance, and investment in research and training and workforce development in an age of localism and austerity. For example, DrugScope will continue to work with the Substance Misuse Skills Consortium to promote its skills framework and skills hub and through the Federation of Drug and Alcohol Professionals to support professional and practice standards.

DrugScope enters 2014 as a member of the Recovery Partnership with the Skills Consortium and Recovery Group UK. No doubt the idea of 'recovery' will continue to be discussed and contested in 2014. A bit of controversy is no bad thing, it helps to keep ideas alive and prevents them from ossifying into dogma and bureaucratic formulation and application. For DrugScope, the idea of recovery as regaining something lost or taken away has always been the critical one, both in terms of the empowerment of individuals and the fight for social integration and justice - for example, through our work on multiple need and disadvantage as part of the Making Every Adult Matter Coalition or the priority we continue to give to the impacts of welfare reform.

Entering 2014, the task of 'building recovery' can be shaped and informed by a growing body of evidence and experience, including the Strang Report on the role of medications in recovery and the landmark report on recovery published by the Advisory Council on the Misuse of Drugs in December. This is the approach that will guide and inform our work going forward.

The public health agenda provides an historic opportunity to widen and diversify the 'sector's' role in local communities, our influence and reach. Drug and alcohol issues pervade our culture and society - that's why substance misuse services have something to contribute to such a broad range of public health priorities. This is an opportunity to broaden our horizons - for example, in responding to concerns about new psychoactive substances, developing services and interventions for young people and young adults, working with equality and diversity groups (such as the LGBT community, older people and migrants), supporting families and contributing to interventions around domestic violence and child safeguarding and responding to new demands for harm reduction, prevention and early intervention. For example, we will be publishing a briefing on drugs and older people later this month.

There is no doubt about the challenges ahead: the risk of disinvestment is real, and there is a risk that in more challenging times the sector could find itself revisiting some of the polarised debates that were holding it back some years ago.

But I enter 2014 feeling energised and optimistic. Drug and alcohol policy is firmly on the radar at national level. There have been strong hints that a new Health Premium will provide a financial incentive for local authorities to continue to invest in drug and alcohol services. Localism combined with the new public health agenda creates an opportunity to 're-vision' what we are about as a sector and as a broad movement for social change.

In particular, while stigma is a key issue for us, I am heartened that a DrugScope/ICM public opinion poll conducted in 2009 found that nine out of ten people believed drug treatment should be available to anyone with a drug problem who was prepared to address it. Tellingly, one in five said they had direct or indirect experience of 'drug addiction', if we widened that out to include alcohol and other sorts of drug problems then the number would be very much higher. This suggests there is an opportunity to begin a different kind of dialogue with the public than we have had in the past at a time when localism is demanding that we are much more outward facing in our engagement with local communities. DrugScope's media and communications work will continue to reach out to this wider audience and help to create spaces for these discussions.

DrugScope will be doing everything we can to support you, including a strategic review of all our activities in early 2014 to ensure that we are focussing our resources in the best possible way to add value and provide voice, representation and support. Can I end with good wishes for the New Year, particularly to all of our members – and if you’re not a member why not start the year by joining us?

Find out about DrugScope membership and join here

Known unknowns and unknown unknowns: minding the gaps in young people’s treatment statistics

The release of the figures on young people's treatment for 2012-13 by Public Health England would seem to show a continuing decline in demand and further improvements in performance. The numbers of young people under 18 accessing treatment fell from a peak of 24,053 in 2008-09 to 20,032 in 2012-13, with Public Health England observing that “this reflects the overall decline in alcohol and drug use by young people over recent years”. That said, it is stressed that alcohol and cannabis continue to cause problems for some young people, while new problems are being created by club drugs and new psychoactive substances. The numbers of young people receiving help with club drugs rose from 2,007 in 2011-12 to 2,834 in 2012-13. Problems with heroin continue to affect only a very small minority: 175 in 2012-13.

The performance of the system is also encouraging. The statistics record an improvement in waiting times, with 99 per cent of young people waiting fewer than three weeks for treatment and an average wait of two days. Around four fifths of young people coming into specialist treatment services left having 'successfully completed' in 2012-13.

The figures are particularly striking in a period when local authorities have been managing cuts to their budgets. Young people's services have historically been more dependent on local funding sources than adult treatment and therefore should be more vulnerable to cuts when local budgets are squeezed.

In addition, there has been less drive and leadership from national government on young people's drug and alcohol services, compared to the strong interest at senior ministerial level in adult treatment and the challenge of 'building recovery in communities'. Indeed there is a general feeling that the Department for Education - in contrast to the former Department for Children, Schools and Families - has stepped back from drug policy. That service provision appears to be holding up in such circumstances is encouraging.

It does, however, raise the question of whether these statistics tell the whole story. When I was at Nacro, the crime reduction charity, we were constantly warning journalists and others of the perils of using statistics on offences recorded by the police as a guide to crime rates (incidentally, police figures are still being used for local crime mapping). For example, when the police improved procedures for reporting and recording racist crime following the Macpherson Report on the murder of Stephen Lawrence, this resulted in an increase in recorded racist crime. This was a good thing, reflecting a greater willingness to report, record and follow up on these offences.

Somewhat similarly, the numbers of young people accessing and being referred to treatment and the availability of treatment are not wholly independent variables - put crudely, you can only refer someone into a treatment service if there is one to refer them to.

Nor is there a direct and unmediated relationship between the overall numbers of young people using drugs and alcohol and the need for specialist treatment, so that a fall in one will necessarily explain a fall in the other.

Only a tiny proportion of under-18s using substances will ever require specialist support and a whole range of other factors tend to come into play where they do - such as experience of trauma and abuse, problems in education, offending, mental health and social exclusion. I'd treat the claim that a fall in the numbers accessing treatment is necessarily explained by overall decline in the much larger numbers who are using drugs and/or alcohol with some caution - which is not, of course, to deny that the decline is relevant and may well be significant too.

Nor, of course, and as Public Health England recognise, do figures on the availability of specialist drug and alcohol services for young people tell the full story about the need for and availability of interventions. Most young people experiencing problems where substance  misuse is a factor are unlikely to ever come into contact with specialist services, but may seek support (or fail to do so) from GPs and other primary care services, mental health services, mainstream children and young people’s service and through other routes.  Less is known about the quality and availability of this support.

I’ve just attended the launch of the Young Mind’s report Same old, about young offenders and mental health, and the problems in accessing services – so it’s also relevant to note that the PHE figures exclude the young people’s secure estate.

All in all, the figures provide grounds for cautious optimism, but it will be important to keep a close eye on interventions for young people during a period of change and transition for local authorities, and with new drug trends too.

The PHE report Substance misuse among young people in England 2012-13 is at  http://www.nta.nhs.uk/uploads/ypstats2012-13commentary[0].pdf

The Young Minds report Same old – the experiences of young offenders with mental health needs is at http://www.youngminds.org.uk/assets/0000/9472/Barrow_Cadbury_Report.pdf

DrugScope’s website for 11-14 year olds – D world - is at  http://www.drugscope-dworld.org.uk/

December’s policy blog was written by DrugScope’s Director of Policy and Membership, Marcus Roberts.