Adolescence
32
Substance Misuse in Young People
K.A.H. Mirza
1
, Roshin M. Sudesh
2
, and Sudeshni Mirza
3
1
Department of Child and Adolescent Psychiatry, Institute of Psychiatry at the Maudsley, King’s College,
London, UK
2
King’s College Hospital, London, UK
3
Dr. Somerwell Memorial CSI Medical College Hospital, Kerala, India
INTRODUCTION
Substance misuse is a major public health problem,
with substantial levels of morbidity and mortal-
ity. Most children in their middle childhood are
exposed to various substances including alcohol
and tobacco, and a substantial minority, as high
as 10%, continue to use drugs into adolescence
and adulthood [1,2]. Many youngsters who mis-
use drugs have multiple antecedent and coexisting
mental health problems, unrecognized learning
difficulties, family difficulties, involvement with
the justice system and deeply entrenched social
problems. Substance misuse takes a high toll in
terms of health-care costs, violent crimes, acci-
dents, suicides, social and interpersonal difficulties,
and educational impairment [3].
EPIDEMIOLOGY
Estimates from the 2009/10 British Crime Survey
suggest that 40% of those aged 16–24 have used
one or more illicit drugs at some point in their
life, with up to 12% having used illicit drugs in
the last month [4]. Tobacco, alcohol and cannabis
are the most commonly abused substances, with
cocaine and heroin accounting for less than 10%
[4,5]. Volatile substance use peaks in early ado-
lescence: about 4–7% of 11–15-year-olds sniffed
volatile substances in the last year, and roughly 1%
inhale solvents regularly, with the prevalence being
substantially higher for youngsters from deprived
backgrounds [3] (Table 32.1).
Child Psychology and Psychiatry: Frameworks for practice
, Second Edition. Edited by David Skuse, Helen Bruce,
Linda Dowdney and David Mrazek.
2011 John Wiley & Sons, Ltd. Published 2011 by John Wiley & Sons, Ltd.
Most of the campaigns against substance misuse
are directed at illegal drugs such as cannabis,
heroin, cocaine and ecstasy. However, many more
people die or develop problems, either directly or
indirectly, as a result of using tobacco and alco-
hol than all illegal drugs combined, and some of
the leading experts in the field of addictions have
proposed alternatives to the contentious British
system of classification of drugs [6].
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