information sheet Drug &

information sheet Drug & Alcohol Use Children and young people s experience of drug and alcohol use, either their own or another s. Substance use is an all-too-common practice among Australians, young and old. One-in-five Australians aged 14 years and older consume alcohol, at either short-term risk or high risk levels, at least once a month. 1 In addition, over 35% of this cohort has used illicit drugs, with 13% reporting use in the 12 months prior to being surveyed. 2 The most common forms of substance used by young Australians include nicotine and alcohol. Among illicit drugs, marijuana, ecstasy, non-medical use of prescription drugs and crystal meth/amphetamines (including Ice ) are reportedly the most common. For most young people, substance use is experimental and relatively unproblematic. However, some young people develop drug dependencies that can lead to major long-term impacts on their physical, psychological and social wellbeing. 3 Short-term impacts of substance use can also be harmful. On average, one-in-four young people aged 15 to 24 years are hospitalised because of alcohol. 1 Evidence also shows the use of alcohol and drugs is related to increased rates of risky sexual behaviour, often due to impaired judgment. Such behaviour can then place adolescents and their partners at risk of becoming pregnant or contracting sexually transmitted infections (STIs) and HIV. 4 The risk of being cyberbullied can also increase when image-capturing technology (such as mobile phones) is combined with such behaviour. Other harms resulting from the misuse of drugs and alcohol include assault or injury, relationship problems, poor school performance and psychological and behavioural problems. Drug use has also been found to increase the risk of bringing young people in contact with the law. 5 In addition to personal impacts, the total social and economic costs associated with alcohol and drug use each year in Australia are significant. 6 Recognising this, the Australian Federal Government launched their Kids and Alcohol Don t Mix campaign in 2009 in order to combat risky drinking by encouraging responsible drinking. In line with research highlighting the important role parents play in the alcohol consumption of youth, 1 the campaign targeted young people, adults, parents and carers. 7 The Kids Helpline Experience Kids Helpline offers Australia s only free 24/7 national telephone and online counselling service for Australian young people aged 5 to 25 years. During the five year period 2006-2010, Kids Helpline responded to almost 5,000 contacts where drugs or alcohol were the primary concern. A further 1,786 contacts recorded drugs or alcohol as a secondary concern. Through qualitative analysis of client case notes, it is evident that additional substance-related contacts were also made, subsumed under other 1

problem classifications such as relationship difficulties, homelessness, mental health, suicide and child abuse. Drug use included prescription or illegal drugs, nicotine, petrol sniffing, etc, from experimentation to overdose. Alcohol use included behaviours ranging from occasional use to alcoholism. For the past five years, drug and alcohol concerns have remained one of the top 15 primary issues of young people contacting the service. Whilst the proportion of drug-related contacts has shown a slight but steady decline (-0.6%), the proportion of counselling contacts relating to alcohol use has remained relatively stable, as shown in Figure 1. figure 1 FIVE YEAR TRENDS OF THE PROPORTION OF ALL PRIMARY COUNSELLING CONCERNS RELATED TO ALCOHOL OR DRUGS YEAR 2006 2007 2008 0.5% 0.6% 1.3% 1.5% 1.7% Age and Gender Drug or alcohol related contacts are typically represented by an older cohort than for counselling contacts overall. In 2010, more than 80% of drug and alcohol contacts were represented by young people aged 15 to 25 years. In contrast, this cohort represented 72% of all counselling contacts. The greatest discrepancy was seen among contacts aged 19 to 25 years, as shown in Figure 2. figure 2 AGE DISTRIBUTION OF SUBSTANCE RELATED CONTACTS COMPARED TO ALL COUNSELLING CONTACTS AGE GROUPS 5 to 9 10 to 14 15 to 18 19 to 25 1.0% 2.1% 13.7% 16.3% 25.8% 28.4% 32.5% 43.1% 50.8% 43.6% 42.1% 2009 1.2% 0% 10% 20% 30% 40% 50% 60% 2010 0.9% ALCOHOL DRUGS ALL COUNSELLING 0% 0.2% 0.6% 0.8% 1.0% 1.2% 1.4% 1.6% 1.8% ALCOHOL DRUGS Emily * (aged 17 years) called Kids Helpline because she was worried about her father who was injecting drugs. The drug use was affecting his mental health and he had previously tried to hang himself and ended up being admitted to a psychiatric hospital. She said he frequently tells her that he wishes he was dead. Emily told the counsellor that she wanted advice on how to help her father but that she also wanted to move out as the stress was becoming too much for her. The counsellor validated Emily s feelings and provided her with a number of referrals to services she could contact to assist her father and find alternative accommodation. *name changed for privacy reasons 2

Males were over-represented in substance-related contacts, particularly in relation to drugs where they represented 47% of these contacts compared with only 19% of all counselling contacts. Conversely, females represented 70% of alcohol-related contacts and the remaining 53% of drug-related contacts. Cultural Background Counsellors were able to record the young person s cultural and linguistic background for 51% of contacts in 2010 regarding substance use concerns. Of these, the majority were from young people of Anglo-Australian background (82%). The remainder were of Aboriginal or Torres Strait Islander (11%) or non-english speaking (8%) backgrounds. Young Aboriginal people were over-represented in issues relating to drug and alcohol use being three to four times more likely to contact Kids Helpline regarding drugs (11%) or alcohol (10%) than for other problem types (2%). In contrast, non-english speaking contacts were under-represented, representing 7% of alcohol and 8% of drug-related contacts, compared with 20% of all counselling contacts. Geographic Location The majority of substance-related counselling contacts in 2010 were from metropolitan areas. For young people living in regional and remote areas, the proportion of drug-related contacts (33%) mirrored the proportion seen for all counselling contacts. However, alcohol-related contacts were over-represented among regional and remote counselling contacts (41% compared with 31%). Consistent with population size and the geographic breakdown of all counselling contacts, the majority of substance-related contacts were from New South Wales (31%), followed by Victoria (30%) and Queensland (21%). Alcohol-specific contacts were over-represented in Queensland (30% compared with 24% of all counselling contacts). In addition, drug-related contacts were over-represented in Western Australia (14% compared with 7% of all counselling contacts). When interpreting this data, it is important to note that the higher proportion of contacts does not necessarily equate to a higher level of drug or alcohol use. For example, the higher level in Western Australia may be due to young people feeling more comfortable with seeking help due to drug education. Mode of contact Kids Helpline provides counselling to children and young people via phone, email and real-time web counselling. Although phone contact still dominates, the past five years has seen an increasing preference toward online modalities. In 2010, the phone was more likely to be used for substance-related issues than counselling contacts in general (86% compared with 67%). Interestingly, online alcohol-related contacts almost doubled from 2009 to 2010 (10% to 19%), whilst online drug-related contacts dropped slightly (15% to 11%). Geoff * (aged 14 years) told his counsellor that he had been sniffing marker pens daily for the past month. He said he enjoyed the feeling he experienced for a few minutes after sniffing them but that it causes him to feel sick the next day. Geoff felt he was addicted to them and didn t know how to stop. He also said he has used other types of inhalants such as deodorant in the past. He had started sniffing because his friends were doing it as well. The counsellor discussed with Geoff the potential risks of using inhalants and referred him to a faceto-face counselling service. The counsellor also recommended he reconnect with Kids Helpline if he needed further assistance. *name changed for privacy reasons 3

Nature and severity of alcohol-related concerns The proportion of alcohol-related contacts where the young person was concerned with their constant use of alcohol peaked in 2009 before dropping back to a more typical rate of 15% in 2010. In contrast, a reversed pattern was seen in the reports of frequent use and/or binge drinking, returning to 36% of all alcohol-related contacts in 2010 after a short decline to 31% in 2009. In addition, one-quarter of contacts reported concern about the alcohol use of a friend or significant other. The remainder of contacts referred to a concern for their own inebriated behaviour (17%) or own experimental or occasional use (7%). Reports of experimental or occasional use were the lowest on record for the past five years, having halved since 2006 s rate of 17%. NATURE OF CONCERN figure 3 SEVERITY OF ALCOHOL-RELATED CONTACTS Constant use Frequent/Binge use Concern for own behaviour when drunk Experimental use Concern for others 7.2% 14.5% 16.6% 25.3% 36.2% 0% 10% 20% 30% 40% Nature and severity of drug-related concerns Like alcohol-related contacts, the nature of drugrelated contacts has also become more severe over the past five years. The proportion of drug-related contacts requiring urgent intervention almost doubled during this period, up to 9%. In addition, almost half (46%) of the drug-related contacts were in relation to a young person s own habitual use. The remainder related to information seeking (16%), concern for own experimental behaviour (13%) and concern about the drug use of a friend or significant other (15%). NATURE OF CONCERN figure 4 SEVERITY OF DRUG-RELATED CONTACTS Urgent intervention Frequent/habitual use Experimental/ occasional use Concern for others Seeking information 9.3% 13.2% 15.1% 16.2% 46.3% 0% 10% 20% 30% 40% 50% Females were three times more likely to make contact in relation to their concern for someone else s drug use. In contrast, males were twice as likely to be seeking information. Males were three times more likely to contact Kids Helpline with a concern requiring urgent intervention. In contrast, females were twice as likely to contact regarding their concern for other peoples alcohol use. Adam * (aged 19 years) contacted Kids Helpline to discuss his cannabis use over the past year. He said it was causing him to feel suicidal and that he also injured himself when he was feeling distressed. He said he was concerned about his wellbeing and wanted to stop using cannabis. He asked the counsellor for a referral to a drug and alcohol service and the counsellor provided him with the contact details of some services in his local area. Adam said he would contact Kids Helpline again in the future if he needed further information. *name changed for privacy reasons 4

Related issues Impacts of substance use In specific relation to substance abuse concerns, qualitative analysis of case notes recorded in 2009 highlighted a number of young people reporting their friend s drug or alcohol use as a contributing factor in their own behaviour. The substance use of older relatives or parents was also reported to have influenced many young people s own substance use. Young people commonly associated drug and alcohol use as both a reason for and a consequence of various emotional issues. For example, some young people reported using drugs (typically cannabis) and alcohol as a way of managing their negative emotions. Others felt extreme sadness or anxiety as a result of their continued drug use. During counselling, it is not uncommon for clients to discuss more than one issue. In 2010, issues most commonly reported as a secondary concern in conjunction with substance abuse included family relationship problems, emotional/behavioural issues and mental health concerns. Problems with peers or partner relationships were also frequently mentioned. In line with existing research,4 young people also often attributed their substance use to certain maladaptive behaviours, many of which posed a direct risk to their safety and wellbeing. Such behaviours commonly included interpersonal conflict (both physical and nonphysical) and/or engaging in unsafe sexual behaviour. Conflict was typically reported with friends, family and/ or partners. Others reported being in trouble with the law as a result of their substance-related behaviour. Types of drugs used Reports of polydrug use were common among young people, often including alcohol and multiple other drugs. Qualitative analysis of 378 case notes recorded in 2009 showed the most common drugs (in order of frequency) to be: Marijuana Nicotine Prescription drugs e.g. Valium, Xanax, Panadeine Forte H eroin Ecstasy Ice (crystal meth) Speed Other reports of drug use included chroming (i.e. sniffing paint), lysergic acid diethylamide (LSD) and cocaine. 5 At its most extreme, substance use was also related to reports of deliberate self-harm (as distinct from suicidality) and thoughts of suicide. Among alcoholrelated contacts, 13% reported engaging in self-injury. Similar results (12%) were seen among drug-related contacts. For both drug and alcohol-related concerns, 3% of contacts reported having thoughts of suicide during their counselling session.

BoysTown s Response to the Issue of Drug and Alcohol Use Kids Helpline plays a vital role in assisting young people to deal with drug and alcohol issues. By providing a safe and confidential environment, counsellors help young people to clearly identify short and long-term consequences of drug and alcohol use and develop strategies for change. Where considered necessary, counsellors refer young people on to appropriate local services. In 2010, referrals were made and accepted for 20% and 29% of alcohol and drug related contacts, respectively. This is three to four times higher than the referral rate for all other problem types. In addition to Kids Helpline, BoysTown actively works to support young people experiencing alcohol and drug problems through the employment of Drug and Alcohol Youth Workers. These staff work across various BoysTown sites to provide specific one-on-one drug and alcohol counselling to young people referred to them by other BoysTown staff. At BoysTown s site in remote Western Australia, staff are also engaged in partnerships with local organisations to address the specific issues behind the use of drugs and alcohol among young Aboriginal people. BoysTown also plays an active role in informing policy related to substance use through submissions provided to State and Federal Government inquiries. In addition, it provides relevant online resources to young people, parents, carers and other adults involved with young people. BoysTown recognises that drug and alcohol use is a major problem among young people, hence it strongly advocates for both individual and community-based interventions to address both the specific and broader social issues, which contribute to drug and alcohol use. In particular, BoysTown supports a coordinated harm minimisation approach which can provide ongoing support in addressing the lack of motivation that some young people have in relation to changing their drug and alcohol use. For substance-related issues among young Indigenous people, BoysTown recognises that an understanding of culture-specific issues is also needed. Links to other resources/websites Adolescent Substance Abuse Knowledge Base: http://www.adolescent-substance-abuse.com/ DrugFree.org s Parent Resource Centre http://www.drugfree.org/parent/ TimeToTalk Drug-Related Conversation Guide http://www.timetotalk.org/ Comprehensive summary of drugs: http://www.timetotalk.org/downloads/ttt_drug_chart.pdf Links to Kids Helpline Hot Topics Substance Use Hot Topic (Teens) http://kidshelpline.com.au/teens/get-info/hot-topics/ alcohol-and-other-drugs.php Resilience Hot Topic (Teens) http://kidshelpline.com.au/teens/get-info/hot-topics/ being-resilient.php Resilience Hot Topic (Kids) http://kidshelpline.com.au/kids/information/ hot-topics/tough-times_1.php Suggested citation BoysTown (2010). Kids Helpline Information Sheet: Drugs and Alcohol Use. Sourced at www.kidshelp.com.au References 1. Alcohol Policy Coalition. (2010, March 14). New national alliance formed to reduce harm from alcohol [Press release]. Retrieved from http://alcoholpolicycoalition.org.au 2. Australian Institute of Health and Welfare (2008). 2007 National drug strategy household survey: Detailed findings. Drug statistics series no. 22. Cat. No. PHE 107. Canberra: AIHW 3. Australian Psychological Society. (2005). Perspectives in psychology: Substance use. Retrieved from http://www.psychology.org.au/ Assets/Files/Perspectives_Substance_Use[1].pdf 4. Lansky, A. & Drake, A. (2009). HIV-associated behaviours among injecting-drug users 23 cities. Morbidity & Mortality Weekly Report, 58(13), 329-332. United States. 5. Australian Bureau of Statistics. (2008). Risk taking by young people. Australian Social Trends 2008, Cat. No. 4102.0, Canberra: ABS. 6. Moore, T. (2007). Monograph No.14: Working estimates of the social costs per gram and per user for cannabis, cocaine, opiates and amphetamines. DPMP Monograph Series, Sydney: National Drug and Alcohol Research Centre. 7. Roxon, N. Minister for Health and Aging. (2009, November 18). Kids and alcohol don t mix. [Press release]. Retrieved from http://www.health. gov.au/internet/ministers/publishing.nsf/content/ D67E720404127695CA25767200192135/$File/ nr214.pdf 20.04.11 6