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Young people's alcohol and substance misuse
Introduction
Substance use amongst young people (under 18 years) carries with it short and long terms risks to health and well-being, the impact of which will depend on the substance(s) used and the frequency their use. Frequent use of illicit substances is not a predominant feature of most most young peoples' lives. For those who do use drugs their orientation is experimental and recreational, usually diminishing by their mid-20s. For some people, however, substance use can become problematic and potentially ascending towards long term heavy use and dependency. Even low level use is not always a protective factor in the context of adulterated substances, purity and the risks of unintentional overdosing.
The prevalence of substance use amongst young people is difficult to estimate. This is due to differing approaches and methodologies, variance in the composition of age cohorts and other factors such as access, safe disclosure and the adoption of rigorous checks and balances designed to ensure reliability and validity. These issues are the main reason for prevalence estimates tending to be applied at national level. The main source of substance prevalence estimates can be found in biennial schools survey 'Smoking, drinking and drug use amoung young people in England' (NHS Digital & Ipsos Mori). This survey, however, only provides data in relation to 11 to 15 year olds (Years 7 to 11). Although this age range differs from the 'Under 18s' age cohort, that comprise the in-treatment population, profiled below, it does offer a flavour of young peoples' experience and encounters with illicit substances. Analysis of the raw data from the most recent survey in 2023 has revealed the following key points:
Alcohol:
- 35.6% of respondents aged 11-15 years old have had 'a proper alcoholic drink' - 14.6% at 11 rising to 60.7% by 15
- 14.2% of 11-15 year olds indicated had been drunk - 3.0% at 11 rising to 34.1% by 15
Smoking and vaping:
- 9.3% of 11-15 year olds have tried cigarettes - 4.2% at 11, up to 19.8% at 15
- 1.9% had smoked cigarettes/tobacco within last 7 days - rising from 0.5% at 12 to 4.4% at 15
- 5.3% of 11-15 years old regarded themselves as regular 'vapers' - increasing from 1.8% at 11 to 12.5% at 15
Drugs:
- 12.3% of 11-15 years old indicated that they had used drugs - 5.5% of 11 year olds, rising to 24.1% of 15 year olds
- Cannabis use was indicated by 6.3% of respondents - 1.1% of 11 year olds, rising to 17.5% of 15 year olds
- Class A drugs use was cited by 3.3% or 11-15s - 1.5% amongst 11 year olds increasing to 7.4% of those aged 15
- 5.4% of 11-15 years old had used drugs within the last month - 2.9% at 11 up to 11.5% by 15
Hospital admission episodes for alcohol-specific conditions amongst under 18 year olds
The charts below show that admission episodes for alcohol-specific conditions amongst young people aged 0 to 17 year old in Oldham has fallen considerably over the past 10 years. Indeed, Oldham's rate has dropped by 83% from 63.5 to 10.7 (per 100,000 population) placing the borough in the lowest quintile in England for this measure.
In the most recent available data Oldham's rate of 10.7 per 100,000 population sees it ranked second lowest out of the ten boroughs that make up the Greater Manchester Combined Authority (GMCA) with Bury recording the lowest rate (9.9) and Tameside the highest (30.4) - almost three times that of Oldham.
Summary profile of young people in treatment for substance misuse in Oldham
This section contains data, information and a summary profile in relation to the nature and impact of substance misuse amongst young people (under 18) engaged with treatment services in Oldham.
Figure 1 below shows data in relation to the demographic make-up of Oldham’s young people in-treatment population from 2022/23 to 2024/25. In 2022/23 the ratio was 61:39 males to females, in the most recent period of 2024/25 males accounted for more than two-thirds (67%) of the in-treatment population. In terms of ethnicity, the largest concentration can be found amongst young people from ‘White/White British’ ethnicities, typically ranging from 67% to 70% of those in treatment. Young people from ‘Asian/Asian British’ backgrounds had the second highest concentration with around 10% to 12%. The proportion of young people from 'Black/Black British' ethnicities has increased almost eight-fold to over 6% while those from ‘Mixed/Dual Heritage background has decreased from 8% to less than five percent. In 2024/25 the proportion of Young People with their ethnicity recorded as 'Not stated' exceeded 10% - the highest rate for many years.
Figure 1 above also shows that the age cohort with the greatest proportion can be found amongst 13-14 year olds, averaging 33% across the three census periods, followed by 15 year olds albeit with rates dropping from around 30% towards 27%. The pattern amongst 16 year olds is similar but at lower levels. The age cohort with the largest increases was amongst 17 year olds - up from 9% in 2022/23 to 16% in 2024/25. The number of under 13s has also increased of this period but from lower levels, however any sustained increases amongst such a young cohort would provide cause for concern.
The Treatment Journey for Young People in treatment for substance misuse in Oldham
Numbers in treatment and new presentations
Figure 2 below shows the numbers in treatment and new presentations to treatment for substance misuse amongst young people from Oldham from April 2017/March 2018 to April 2024/March 2025. Following a broadly 'plateauing trend' from the earliest census period to March 2021, numbers in treatment and new presentations have increased considerably over the past four years – in both instances the highest levels of treatment engagement in the eight years on view have been recorded. The number in treatment has more than quadrupled while new presentations increased almost six-fold.
Across GM Oldham has the fourth highest rate of young people in treatment services for substance misuse with 2.73 per 1,000 of the 0-17 population. Bolton has the highest with 3.16 and Salford the lowest with 1.17. Oldham’s rate is 25.8% greater than the GMCA average (2.17 per 1,000), 44.4% higher than the North West rate (1.89) and more than double the England average of 1.33.
Referral sources
Figure 2 above also shows referral sources amongst young people newly presenting to treatment services over the past three years in Oldham. In 2022/23 referrals from ‘Education Services’ accounted for the highest proportion with 45%, however, by 2024/25 referrals from this source had dropped by ten percentage points. During the same period referrals from ‘Children & Family Services’ increased modestly from 21% to 24%. ‘Health & Mental Health’ services are currently the third most common referrer with almost 20%. Within this category more than half were ‘hospital’ referrals, accounting for 11% of all referrals – four times the England average of 2.7%. ‘Self, Family & Friends’ currently account for approximately one-in-nine referrals, while those from 'Youth Justice' in 2024/25 were double the rates for previous two census periods.
Length of time in treatment and treatment exit status
Figure 2 above also shows that on average young people remain in treatment for 24 weeks, four weeks longer than the England average of twenty weeks. Approaching half (44%) of the young people in treatment for substance misuse England are in treatment for '0 to 12 weeks' compared to 27% in Oldham.
Figure 2 above also illustrates treatment exit status amongst those discharged from treatment for young people. In 2022/23 the proportion of planned exits completed ‘drug free’ was 27%, increasing one-and-a-half times to 41% in 2023/24 but falling back to 32% in 2024/25 (England average: 35%). Planned discharges where the young person was classed as an ‘occasional user’ decreased from 58% in 2022/23 to 51% in 2024/25 – similar to the England average of 49%. Over the same period unplanned exits where the client ‘dropped out’ of treatment increased from less than 13% to 17% - higher than the national average of 10%.
Accommodation status amongst young people in treatment for substance misuse in Oldham
‘Accommodation status’ amongst Oldham’s young people in treatment for substance misuse is shown in Figure 3 below. In 2022/23 ‘NFA (i.e. No Fixed Abode) - urgent housing need’ was 7.1% dropping to less than five percent in 2023/24. In the most recent period (2024/25) the proportion rose to one-ninth (11%) – more than six times the England average of 1.7.%. The vast majority of young people in treatment (typically 90%) described their accommodation as ‘settled’ (England average: 85%).
Education, employment and training status amongst young people in treatment for substance misuse in Oldham
Figure 3 also illustrates the distribution of young people in treatment services in Oldham by ‘Education, Employment and Training Status’ from 2022/23 to 2024/25. In both 2022/23 and 2023/24 the proportion of those indicating they were in ‘Alternative education’ was 69% to 70%, by 2024/25 such indications fell by one-fifth to 57% (England average: 61%). During the same period indications for ‘Mainstream education’ have been consistently lower than 5%.
Figure 3 above also shows that the proportion of young people experiencing temporary exclusions across the three census periods ranged from 18% to 20% - similar to the national average (17%). The proportion of records with missing data has almost doubled from 8% in 2022/23 to 15% in 2024/25.
Substance use and interventions amongst young people in treatment for substance misuse in Oldham
Substance use
Figure 4 below shows substance use indicated amongst young people in treatment for substance misuse in Oldham 2022/23 to 2024/25. Cannabis is almost ubiquitous in nature with more than nine in ten of this young cohort citing its use. Alcohol is second most commonly recorded substance, however, indications for its use have dropped from 33% in 2022/23 to 20% in 2024/25. Indications of the use of Cocaine (powder) are currently around 6%. From a historic perspective this is very low when proportions of 16% to 20% were recorded as recent as 4-5 years ago.
Treatment interventions for young people in treatment for substance misuse in Oldham
Figure 4 above also shows an overview of structured treatment interventions for young people in treatment for substance misuse in Oldham. ‘YP harm reduction’ interventions ranged from 96% to 100% over the three census periods (England average (2024/25): 75%). The rate for ‘YP multi-agency working’ in Oldham has increased from 84% in 2022/23 to 92% in 2024/25. Again, the most recent rate for Oldham is significantly greater than the England average of 61%.
Rates for ‘Psycho-social interventions’ have been provided for 99% to 100% of Oldham’s young in-treatment cohort and compares favourably, albeit only marginally, with the England average of 95% (2024/25).
In Figure 4 the distribution of ‘psych-social sub-interventions’ is also shown for Oldham’s young people in treatment for substance misuse from 2022/23 to 2024/25. It can be observed that over the three census periods on view ‘Cognitive/Behavioural’ sub-interventions have ranged from 36% to 42% (England average: 30%). A similar range for ‘Motivational interventions’ is also apparent 37% to 43%, less than the national average of 53% (2024/25).
Some concluding comments
Overall while numbers in treatment and new presentations amongst young people in Oldham have increased considerably over the past four years could be taken as an indication of greater availability and use of illegal and illicit substances within the wider community. Such a scenario may also show that young people, their families and support networks are recognising the potential impact of substance use not only themselves but also on those close to them, as well as the wider community. The increase in Oldham's young in-treatment population may also be attributed to how young people view the quality of their engagement and/or treatment journey with the current treatment provider. Increased numbers in treatment can be viewed as 'a positive' so long as its impact on the provider is sustainably managed with regards to capacity.
With regards to other potential highlights that have been revealed from this profile, it is clear that some changes are afoot. One example of this can be seen in Figure 4 above which shows that while indications for use of cannabis have remained unchanged over the last three years, those for alcohol and cocaine have fallen markedly. In the case of alcohol, indications for its use 5 to 10 years ago would have been typically in the region of 45-55% instead of 20% for the most recent period (2024/25). Furthermore, the rate of 'admission episodes for alcohol-specific conditions' amongst under 18s has fallen significantly from one of the highest rates in England to amongst the lowest.
Finally, with regards to cocaine, indications of its use upward of 15% would not have been unusual 5 to 10 years ago - 150% greater than that recorded for the most recent period in this report.