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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 March 31; 334(7595): 657.
PMCID: PMC1839232

Tackle substance misuse in young people early, says NICE

New standards to help prevent vulnerable children and young people from getting involved in substance misuse are being launched for clinicians and non-clinicians alike.

Standards from the National Institute for Health and Clinical Excellence (NICE) call for anyone who works with young people to identify those who are vulnerable to drug problems and to intervene at the earliest opportunity.

NICE wants to help young people before they start using drugs or before they get into more serious problems if they are already misusing substances.

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

Vulnerable young people are defined as those who are excluded from school; who have been in care; or whose parents misuse drugs. These groups, together with serious or frequent offenders, are on average five times more likely to use illegal drugs than their peers.

There are currently more than 70 000 problematic drug users in England between the ages of 15 and 24.

NICE's recommendations include:

  • Developing and implementing a strategy to reduce substance misuse among vulnerable young people, as part of a local area agreement between different agencies;
  • Using existing screening and assessment tools to identify vulnerable young people and work with various agencies such as education welfare services, children's trusts, and school drugs advisers to provide support;
  • Offering vulnerable 10-12 year olds, who are often aggressive or disruptive, group based behavioural therapy over one to two years before and during their move to secondary school and offering their parents or carers group based training in parental skills.

Peter Littlejohns, clinical and public health director at NICE and executive lead for the guidance, said, “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.

“It is important that a national standard is set for tackling this issue so that we can do everything possible to prevent all those at risk, wherever they are, from developing a serious drug problem.”

The recommendations could be implemented by any individual whose role involved interacting with young people in their daily work, said Catherine Law of the Institute of Child Health at University College London and chairwoman of the public health interventions advisory committee at NICE.

“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,” said Dr Law.

Mark Bellis, director of the centre for public health at Liverpool John Moores University, who was also involved in preparing the guidance, added, “The interventions suggested are by no means ‘quick fix' solutions—they involve working with vulnerable individuals and their families over the long-term.”


The guidance is available at

Articles from The BMJ are provided here courtesy of BMJ Publishing Group