More teens seek help for cannabis use

Behind the Headlines

Friday November 2 2012

Skunk has been linked to an increased risk of mental illness

New and more harmful strains of cannabis could be responsible for the growing number of teenagers needing specialist help after using the drug, The Daily Telegraph reported today.

The story comes from a new report on use of treatment services for substance misuse among young peop. The good news is that the study found that, overall, the number of those under 18 seeking specialist help for drugs and alcohol has fallen over the past year.

The potentially bad news is that the number needing help for cannabis misuse has risen.

The researchers offer several theories about why this may be the case, including that:

  • the increasing use of a potent type of herbal cannabis (skunk) may lead to a corresponding increase in mental health problems related to cannabis use
  • there is wider awareness of the health problems associated with cannabis use, so young people with problems are more likely to be referred to specialist services

The report has been published by the National Treatment Agency for Substance Misuse (NTA), an NHS special health authority. The NTA was set up to improve the availability and effectiveness of treatment for drug misuse in England.

The report points out that a very small percentage of young people have serious problems with drugs or alcohol. This year’s data show that 20,688 young people used specialist alcohol or drug services – which amounts to 0.4% of the total population of around 5.5 million young people aged 9-17 in England.

The report also highlights the fact that, overall, the number of under-18s needing help for drug or alcohol use has fallen for the third year running and the number treated for problems with class A drugs, such as heroin, cocaine or ecstasy has reduced by more than two-thirds compared with five years ago.

These are encouraging figures that suggest that drug use prevention strategies for young people appear to be increasingly effective.


What are the health risks of cannabis use?

Prolonged cannabis use can affect both physical and mental health, and may cause:

  • feelings of anxiety and paranoia
  • an increased risk of lung disease, including lung cancer (if you smoke cannabis mixed with tobacco)
  • co-ordination problems, which is one of the reasons why drug driving, like drink driving, is illegal

There is some evidence that cannabis can increase the risk of serious mental illness, such as schizophrenia or psychosis, if you already have an increased risk of developing such a condition (for example, if a close relative has a serious mental illness).

What does the report say?

The report found that:

  • The overall number of under-18s accessing specialist substance misuse services has fallen from 21,955 in 2010-11 to 20,688 in 2011-12.
  • The number treated for problems with class A drugs, such as heroin, cocaine or ecstasy, fell from 770 in 2010-11 to 631 in 2011-12.
  • The number seeing specialist services for alcohol misuse fell from 7,054 in 2010-11 to 5,884 in 2011-12.
  • The proportion of under-18s who left specialist services having successfully completed their programme rose to 77% in 2011-12 from 50% five years ago.
  • The number of cases seen by specialist services for help with cannabis misuse was up from 12,784 in 2010-11 to 13,200 this year.


Are these figures part of a significant trend?

Yes. The drop in the number of under-18s accessing specialist services for substance misuse is the latest step in a trend that began in 2008-9, when the number hit a peak of 24,053. It has been declining steadily ever since. This ongoing fall in numbers has happened across misuse of most substances. For example, the number accessing help for alcohol misuse has fallen from a peak of 8,799 in 2008-9, while the number seeking help for class A drugs has also fallen. The increase in those seeking help for cannabis use is also part of a trend.

Cannabis remains by far the most prevalent primary drug that under-18s require treatment for, says the report. In 2008-9 there were 12,642 cases and this number has increased every year since.

While not discussed in the report, the popularity of cannabis with young people could be due to cost and availability. In most areas of the country cannabis is much cheaper than class A drugs such as cocaine.


Why are more young people being treated for cannabis use?

The report says that the rise in the number of people misusing cannabis who need help appears to contradict wider data that indicates fewer young people are using the drug. It suggests there may be several reasons for this discrepancy


First, that stronger strains of the drug (such as the skunk type of herbal cannabis) now available are having a more pronounced effect with prolonged use, raising the likelihood of users needing help.

Second, there is greater awareness of the issues surrounding cannabis use among agencies, such as social and education services, that refer young people to specialist services.

Third, specialist services themselves have become more alert and responsive to the problems that cannabis use can cause for under-18s.


Is treatment for drug and alcohol problems successful?

The report points out that, for young people who need the help and support of specialist services, the prospects remain good. The proportion of those leaving specialist services who successfully completed their treatment was 77% this year, a small rise on last year and a great improvement since 2005-6 when just 48% of those leaving had completed treatment successfully. Similarly, the proportion of those who drop out of treatment has continued to fall from 29% in 2005-6 to 12% in 2011-12.

The report reveals that 44% of under-18s who came for specialist help this year required a psychosocial (‘talking therapy’) intervention alone. A further 35% needed talking therapy in conjunction with harm reduction advice and 1% required prescribed medication.

It also says that most young people don’t need to spend long in specialist services, with the average length of a treatment episode being just over five months.


What else did the report say?

The report’s figures also suggest that young people referred for specialist help face a wide range of problems, with substance misuse seldom an isolated issue. Of those who came for help 76% reported two or more further problems including using drugs when under 15, using two or more drugs, drinking alcohol daily, and wider issues such as pregnancy, self-harming and offending.

On the other hand, 80% of those accessing services were living with their family or other relatives and almost half were in mainstream education. These figures suggest that some young people with substance misuse problems may also come from relatively stable homes and be settled at school or college. About two-thirds of young people coming for help are male, 85% are white.


What about the future?

The report concludes that specialist services for substance misuse are working well, with fewer under-18s needing help from them. For those who do need help, the services are working well. But they warn, “the drop in numbers might be temporary and could quickly be reversed by the long-term effects of the recession and any new drug trends. Alcohol and cannabis remain the key problem substances for this age group and the evidence suggests that those who use them are doing so more intensively than ever”.

Rosanna O’Connor, NTA Director of Delivery, said: “Any substance misuse among young people is a cause for concern. The signs that fewer need help, and that a higher proportion are successfully completing their programme of support, is encouraging.

“The numbers needing specialist interventions remain low and evidence shows that fewer young people are using drugs. However, the advent of new substances and risks of ongoing cannabis and alcohol use in particular present a significant challenge.”

Analysis by Bazian. Edited by NHS Choices. Follow Behind the Headlines on twitter.

Analysis by Bazian

Edited by NHS Choices

Links to the headlines

More teenagers need help for cannabis despite drop in use. The Daily Telegraph, November 1 2012

Children 'no longer interested' in using heroin, cocaine and ecstasy. Metro, November 1 2012

Further reading

National Treatment Agency for Substance Misuse. Substance Misuse Among Young People 2011-12 (PDF, 1.3Mb)



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The 3 comments posted are personal views. Any information they give has not been checked and may not be accurate.

handytrim said on 03 November 2012

In regards to cannabis I would suggest that there is a greater number of younger users seeking help not because of the "skunk" they are smoking but because the cannabis they are currently being sold has been grown by unscrupulous criminals who have little knowledge of growing less harmful cannabis or simply do not care and wish only to maximise profits by usually harvesting their crops too early.

Cannabis when grown correctly should have a percentage of CBD which counterbalances some of the negative side effects of THC such as anxiety and paranoia.

Yes people do enjoy strains that contain larger percentage THC to CBD ratios, but usually these would be people who have smoked cannabis for a longer period of time and are more experienced and used to the differing effects. Someone who has not been smoking very long and is then exposed to a strain that is THC predominate will find the effects perhaps too intense, akin to a drinker going from drinking low alcohol larger to drinking hard liquor, which could lead to some of the symptoms expressed in the article.

If we were to actually take responsibility and control and regulate, as we do with alcohol, cannabis use we would not have these issues. And far more importantly cannabis would not be sold to children by criminals who often
sell much harder drugs at the same time. Whereas currently children have an almost unrestricted access to cannabis just as long as they have the cash.

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Peter Reynolds said on 03 November 2012

The information provided on this page is misleading. It seeks to support a government policy on cannabis which is irrational. irresponsible and dangerous.

Many psychiatrists believe that "cannabis psychosis" is a myth. Even if you accept that tehre may be some correlation between cannabis use and psychosis the number of cases each year is tiny and your claim "that it is responsible for producing extreme psychosis in a large number of people" is nonsesense. Look at the NHS/NTA figures below.

“Cannabis has been used safely for many thousands of years…there have been concerted efforts to demonise the drug’s use.” Professor Tim Kirkham, psychologist, Liverpool University

“I don’t think it causes mental illness. I have never seen a case of so-called cannabis psychosis.” Dr Trevor Turner, former vice president of the Royal College of Psychiatrists

Below is a direct quotation from Professor Glyn Lewis, internationally recognised as one of the leading experts on the causes of psychosis and a member of the team at Bristol and Cardiff universities that has probably published the most papers on the subject of cannabis and psychosis.

"I think it is also important to note that we cannot be certain that there is a causal link between cannabis use and psychosis at present."
Professor Glyn Lewis, March 2011

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Peter Reynolds said on 03 November 2012

Are we so stupid that we cannot learn the lessons of history? If we prohibit something for which there is huge demand then the price rises and violent criminals become involved.

If we introduced a legally regulated system we would solve nearly all the problems around cannabis. Science proves how much safer it is than tobacco, alcohol, prescription medicines and all other recreational drugs. The evidence is that where legal regulation is introduced, consumption by children and health harms are reduced.

Doctors would be able to prescribe one of the most effective medicines that has no serious side effects at all. At the moment the government has given GW Pharmaceuticals an monopoly on cannabis so they make millions out of a medicine that you can grow in your greenhouse for virtually nothing

Our present policy on cannabis is irrational, irresponsible and dangerous. Washington and Colorado look set to introduce legal regulation of cannabis next week. Then the inevitable change will begin to roll out across the world.

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