Children and young people's substance misuse treatment statistics 2023 to 2024: report
Published 28 November 2024
Applies to England
© Crown copyright 2024
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This publication is available at https://www.gov.uk/government/statistics/substance-misuse-treatment-for-young-people-2023-to-2024/children-and-young-peoples-substance-misuse-treatment-statistics-2023-to-2024-report
Main findings
Trends in treatment numbers
There were 14,352 children and young people (aged 17 and under) in alcohol and drug treatment between April 2023 and March 2024. This is a 16% increase from the previous year (12,418). However, the number in treatment is 41% lower than the peak of 24,494 in 2008 to 2009.
Trends in substance use
Cannabis remained the most common substance (87%) that children and young people came to treatment for.
Around 2 in 5 children and young people in treatment (39%) said they had problems with alcohol use, 9% had problems with ecstasy and 8% reported problems with powder cocaine use.
The number of children and young people in treatment for solvent and inhalant misuse, which includes using nitrous oxide, continued to increase. This has risen from 329 (2.9%) children and young people reporting a problem in 2021 to 2022, to 881 (6.1%) in 2023 to 2024. There was also a rise in the number reporting problems with ketamine, from 512 (4.5%) in 2021 to 2022 to 1,201 (8.4%) this year, which means more children and young people reported problems with ketamine than with cocaine for the first time.
Vulnerabilities among children and young people in treatment
Of the range of problems or vulnerabilities reported by children and young people starting treatment, the most common was early onset of substance use. This means they first started using substances before the age of 15, with 4 in 5 children and young people (80%) reporting this. This was followed by polydrug use (using multiple substances), which affected 56% of children and young people.
Girls tended to report some vulnerabilities more than boys, particularly self-harming behaviour (52% compared with 17%) and sexual exploitation (9% compared with 1.2%).
Mental health treatment need
Nearly half (49%) of children and young people starting treatment this year said they had a mental health treatment need. This has risen each year since 2018 to 2019, when 32% reported a mental health treatment need. A higher proportion of girls reported a mental health treatment need than boys (65% compared to 40%).
Most children and young people (72%) who reported a mental health treatment need received some form of treatment, usually from a community mental health team.
Treatment exits
Of the children and young people who left treatment during the year 85% left because they successfully completed their treatment programme. This is higher than the previous year’s proportion (83%) and is the highest since records began in 2005 to 2006. The next most common reason for leaving treatment (11%) was dropping out before completing treatment, which is the same proportion as the previous year.
Age and sex of children and young people in treatment
There were 14,352 children and young people (under the age of 18) in contact with drug and alcohol treatment services between 1 April 2023 and 31 March 2024. Almost two-thirds were boys (62%), a similar proportion to the previous year. The median age was nearly 16 years old for girls and for boys.
The number of younger children (under 14) in treatment remained low (1,459, 10%).
Figure 1: age and sex of children and young people in treatment
| Age group | Girls | Boys |
|---|---|---|
| Under 12 | 20 | 34 |
| 12 years old | 151 | 145 |
| 13 years old | 525 | 584 |
| 14 years old | 1,077 | 1,550 |
| 15 years old | 1,489 | 2,462 |
| 16 years old | 1,122 | 2,113 |
| 17 years old | 1,112 | 1,968 |
Substances used by children and young people
When children and young people enter treatment, they can record up to 3 substances that they have a problem with. Numbers in this section are based on all substances recorded during their treatment, so each child or young person may be counted more than once.
Figure 2 shows the number of children and young people in treatment that report having problems with different substances. Most children and young people in treatment (87% of all in treatment) said they had a cannabis problem. Almost 2 in 5 (39%) said they had a problem with alcohol.
The section on trends over time in this report shows the numbers of children and young people in treatment and the substances they had problems with since 2005 to 2006.
Figure 2: problem substances reported by children and young people
| Substance | Number of children and young people |
|---|---|
| Cannabis | 12,554 |
| Alcohol | 5,605 |
| Nicotine | 2,383 |
| Ecstasy | 1,329 |
| Ketamine | 1,201 |
| Cocaine | 1,156 |
| Solvents | 881 |
| Other | 489 |
| Benzodiazepines | 217 |
| Codeine | 132 |
| Psychoactive substances | 118 |
| Other opiates | 96 |
| Amphetamine | 81 |
| Crack | 69 |
| Heroin | 28 |
Notes on the figure:
The solvents category includes inhalants such as pressurised gases and aerosols.
Psychoactive substances are drugs made illegal by the Psychoactive Substances Act 2016. These are mainly synthetic cannabinoids, previously recorded as ‘new psychoactive substances’.
Other drugs include prescription drugs (such as barbiturates, tranquilisers and anti-depressants), hallucinogens other than ketamine, and caffeine.
Nicotine can only be reported alongside other problem substances.
Referral routes into treatment
The most common route to get into treatment was a referral from education services, with 3,310 or 32% of children and young people entering this way.
This is similar to the proportion of education referrals in 2022 to 2023 (31%). Education service referrals have now fully returned to pre-pandemic levels, following a sharp decline from this source during the COVID-19 pandemic. In 2019 to 2020 there were 3,196 referrals from education services, comprising 32% of all referrals. During the first year of the pandemic (2020 to 2021) the proportion of referrals from education fell to 18%, while the total number of referrals from education services fell by 60% (1,912 fewer referrals). This was a much greater decline than referrals from other sources (16% decline, 1,114 fewer referrals).
The second most common route for children and young people to get into treatment services was a referral from social care, making up 23% of all referrals. This was the same proportion in 2022 to 2023.
Figure 3: referral routes into treatment
| Referral route | Number of children and young people |
|---|---|
| Education | 3,310 |
| Youth justice | 1,683 |
| Social care | 2,419 |
| Self, family and friends | 1,252 |
| Alcohol and drug treatment service | 231 |
| Health | 1,270 |
| Other | 225 |
Note on the figure: ‘other’ referral routes include non-alcohol and drug treatment outreach services, helplines, housing services and domestic abuse services.
Vulnerabilities of children and young people in treatment
Vulnerabilities reported
Children and young people often enter alcohol and drug services with a range of problems or vulnerabilities related to (or in addition to) their substance use. Vulnerabilities are reported here only for children and young people who entered drug and alcohol treatment services during 2023 to 2024.
The most common vulnerability was early onset of substance use (80%), which means the child or young person started using substances before the age of 15. Girls reported this more than boys (84% and 79% respectively). The second most common vulnerability was polydrug use (56%). Again, girls tended to report this more than boys (63% and 51% respectively).
Girls tend to report some vulnerabilities more than boys, particularly for self-harming behaviours (52% compared with 17%) and sexual exploitation (9% compared with 1.2%). In comparison, boys reported more criminal exploitation (11% compared with 4.6%) and were more likely to be not engaged in education, employment or training (16% compared with 12%).
Other vulnerabilities that were reported included:
- being affected by others’ substance use (24%)
- unsafe sex (19%)
- being affected by domestic abuse (19%)
- high risk alcohol use (4.1%)
- being at risk of homelessness (2.1%)
- opiate or crack use (2.4%)
- being pregnant or a parent (1.2%)
- housing problems (0.7%)
- injecting (0.5%)
Being involved with social care services as a looked after child (10%), a child in need (12%) or having a child protection plan (8%) were also recorded as vulnerabilities.
Figure 4: vulnerabilities among children and young people starting treatment
| Vulnerability | Girls | Boys |
|---|---|---|
| Early onset of alcohol or drug use | 3,269 | 5,114 |
| Polydrug user | 2,455 | 3327 |
| High risk alcohol user | 262 | 161 |
| Opiate and/or crack use | 91 | 161 |
| Injecting | 29 | 25 |
| Mental health treatment need | 2,540 | 2,580 |
| Self-harm | 2,045 | 1,120 |
| Unsafe sex | 848 | 1,156 |
| Pregnant and/or parent | 66 | 61 |
| Affected by others’ alcohol or drug use | 1,207 | 1,306 |
| Affected by domestic abuse | 1,002 | 929 |
| Looked after child | 439 | 636 |
| Child in need | 521 | 696 |
| Child protection plan | 382 | 485 |
| Sexual exploitation | 351 | 81 |
| Criminal exploitation | 180 | 687 |
| Involved in gangs | 88 | 472 |
| Not in education, employment or training | 452 | 1,070 |
| Housing problem | 40 | 38 |
| Risk of homelessness | 82 | 135 |
Child sexual exploitation
Child sexual exploitation: definition and guide for practitioners defines child sexual exploitation (CSE) as follows:
Child sexual exploitation is a form of child sexual abuse. It occurs where an individual or group takes advantage of an imbalance of power to coerce, manipulate or deceive a child or young person under the age of 18 into sexual activity (a) in exchange for something the victim needs or wants, and/or (b) for the financial advantage or increased status of the perpetrator or facilitator. The victim may have been sexually exploited even if the sexual activity appears consensual. Child sexual exploitation does not always involve physical contact; it can also occur through the use of technology.
Overall, 4.1% (432) of young people that entered treatment in 2023 to 2024 reported CSE, including 5.9% of 17 year olds and 3.7% of those aged 16 or under.
Of the young people who started treatment in 2023 to 2024, girls reported CSE much more than boys, with 351 girls (9% of all girls) and 81 boys (1.2% of all boys) reporting it.
Among girls, 9.9% of those aged 15 or older reported CSE compared to 7% of those aged 14 or younger. For boys, the proportion reporting CSE was under 2% for both these age groups.
Figure 5: sexual exploitation of children and young people starting treatment
Girls and boys reporting sexual exploitation
| Sex | Number of girls and boys reporting sexual exploitation |
|---|---|
| Girls | 351 |
| Boys | 81 |
Girls reporting sexual exploitation by age
| Age | Number of girls reporting sexual exploitation by age |
|---|---|
| Under 14 years old | 47 |
| 14 years old | 52 |
| 15 years old | 86 |
| 16 years old | 68 |
| 17 years old | 98 |
Mental health needs
Nearly half (49%, 5,120) of children and young people who started treatment in 2023 to 2024 said they needed mental health treatment. A higher proportion of girls reported needing mental health treatment than boys (65% compared to 40%).
Of those reporting a mental health treatment need, 72% were receiving some form of mental health treatment. A higher proportion of girls who said they needed mental health treatment were receiving a form of mental health treatment when they started alcohol and drug treatment, compared to boys (75% compared to 68%).
Most children and young people who reported needing mental health treatment were engaged with community or other mental health services (59%). Figure 6 shows that 1,625 girls and 1,412 boys had this type of mental health treatment.
Smaller numbers received mental health treatment from a GP (263 girls and 301 boys) or within drug and alcohol services (141 girls and 139 boys).
Some children and young people also had an identified space in a health-based place of safety (70 girls and 70 boys) or were engaged with the NHS talking therapies for anxiety and depression service, formerly known as Improving Access to Psychological Therapies (IAPT) (58 girls and 48 boys). A health-based place of safety is a facility where children and young people who are detained under sections 135 and 136 of the Mental Health Act 1983 (amended 2007) can be managed safely so that a mental health assessment can be done.
However, 627 girls and 814 boys (25% of girls and 32% of boys) reported an identified mental health treatment need, but either were not receiving treatment or refused treatment.
Figure 6: mental health treatment received by children and young people in alcohol and drug treatment
| Mental health treatment received | Girls | Boys |
|---|---|---|
| Community or other mental health services | 1,625 | 1,412 |
| No treatment received | 627 | 814 |
| Mental health treatment from GP | 263 | 301 |
| Other mental health treatment | 128 | 118 |
| Treatment within drug and alcohol services | 141 | 139 |
Treatment types
Most children and young people in treatment for drug and alcohol problems received a psychosocial intervention (14,263 of 14,352, 99%). Psychosocial interventions include talking therapies that use psychological, psychotherapeutic and counselling skills to encourage behaviour change.
A structured harm reduction intervention is a type of psychosocial intervention, reported separately here. It involves support to manage risky behaviours associated with alcohol and drug use. This might include behaviours that can cause overdose or accidental injury, for example injecting and polydrug use. In 2023 to 2024, 10,498 children and young people (74% of those receiving an intervention) received a structured harm reduction intervention.
Only 25 children and young people in treatment (less than 1%) received a pharmacological intervention during treatment. These interventions involve medication prescribed by a clinician and can include detoxification, stabilisation, relapse prevention and substitute prescribing for opiates.
Almost all interventions were delivered in a community setting (98%). A small number received interventions in other settings, such as at home, in a residential rehabilitation centre, or in an inpatient unit.
Figure 7: treatment types and settings
| Structured treatment type | Community | Other |
|---|---|---|
| Psychosocial | 14,027 | 287 |
| Harm reduction | 10,279 | 223 |
| Pharmacological | 24 | See note |
Note: figures less than 5 have been suppressed to protect possible identification.
Treatment exits
There were 9,268 children and young people who left treatment in 2023 to 2024. Of those who left, 7,895 (85%) successfully completed their treatment and 990 (11%) dropped out. A further 1.9% left during a transfer to another provider for treatment and 1.8% declined the treatment offered.
Figure 8: treatment exit reasons
| Treatment exit reason | Number of children and young people |
|---|---|
| Completed | 7,895 |
| Dropped out or moved away | 990 |
| Transferred on to another drug and alcohol service | 175 |
| Treatment declined | 169 |
| Other | 31 |
| Retained in secure estate | 8 |
Wellbeing outcomes
At the start and end of treatment, children and young people are asked a series of questions on their wellbeing, scored from 0 to 10. Comparing start and exit scores for children and young people shows an improvement in average wellbeing across all questions at the point when young people leave treatment.
Figure 9: average wellbeing outcome scores at the start and end of treatment
| Question | Average score at start | Average score at exit |
|---|---|---|
| How satisfied are you with your life today? | 6.1 | 7.2 |
| How anxious did you feel yesterday? | 3.6 | 2.7 |
| How happy did you feel yesterday? | 6.0 | 7.0 |
| How well do you get on with your family? | 6.8 | 7.5 |
| How well do you get on with your friends? | 7.9 | 8.2 |
Trends over time
Trends in age and numbers in treatment
There were 14,352 children and young people in contact with alcohol and drug treatment services between April 2023 and March 2024. This is a 16% increase from the previous year (12,418). The number in treatment is 41% lower than a peak of 24,494 in 2008 to 2009.
Data from NHS England’s Smoking, drinking and drug use among young people in England, 2023 showed that until 2014, there was a long-term decreasing trend in the proportion of school pupils reporting that they had ever taken drugs. Since an increase in 2016, which is partly due to the survey starting to include psychoactive substances, the trend has been falling again.
The survey also showed that pupils who tried drugs at an earlier age were more likely to use volatile substances (such as gas, glue, aerosols and other solvents). Two-thirds (66%) of pupils who first took drugs at age 11 took volatile substances. Pupils who first took drugs at an older age were more likely to report taking cannabis. For example, 77% of pupils who first took drugs aged 14 and 72% of pupils who first took drugs aged 15 took cannabis.
Figure 10 shows the trends in the numbers and ages of children and young people in treatment since 2005 to 2006, split into 3 age groups, which are:
- under 14 years old
- 14 to 15 years old
- 16 to 17 years old
The total number in treatment increased from 17,105 in 2005 to 2006 to a high of 24,494 in 2008 to 2009. Since then, the number of children and young people in treatment fell steadily up to 2020 to 2021, which saw a steeper fall to 11,013. Over the last 3 years, there has been a rise to 14,352 children and young people in treatment in 2023 to 2024.
The 3 age groups shown have largely followed these trends since 2005 to 2006. This year was the first year where 14 to 15 year olds were the largest age group in treatment, after 16 to 17 year olds being the largest age group for all previous years. The under 14 group makes up the smallest proportion for all years. The age profile of young people in treatment has been getting progressively younger over the last 4 years.
Figure 10: trends in age and numbers in treatment
| Year | Under 14 | 14 to 15 years old | 16 to 17 years old | Total |
|---|---|---|---|---|
| 2005 to 2006 | 1,504 | 6,386 | 9,215 | 17,105 |
| 2006 to 2007 | 1,770 | 7,858 | 11,579 | 21,207 |
| 2007 to 2008 | 2,060 | 9,238 | 12,982 | 24,280 |
| 2008 to 2009 | 2,069 | 9,187 | 13,238 | 24,494 |
| 2009 to 2010 | 1,890 | 9,206 | 13,069 | 24,165 |
| 2010 to 2011 | 1,643 | 8,651 | 12,261 | 22,555 |
| 2011 to 2012 | 1,533 | 8,219 | 11,497 | 21,249 |
| 2012 to 2013 | 1,487 | 8,151 | 10,963 | 20,601 |
| 2013 to 2014 | 1,275 | 7,801 | 10,606 | 19,682 |
| 2014 to 2015 | 1,211 | 7,628 | 10,026 | 18,865 |
| 2015 to 2016 | 1,157 | 7,205 | 9,161 | 17,523 |
| 2016 to 2017 | 1,337 | 7,076 | 8,436 | 16,849 |
| 2017 to 2018 | 1,402 | 6,899 | 7,601 | 15,902 |
| 2018 to 2019 | 1,289 | 6,529 | 6,959 | 14,777 |
| 2019 to 2020 | 1,204 | 6,446 | 6,641 | 14,291 |
| 2020 to 2021 | 740 | 4,280 | 5,993 | 11,013 |
| 2021 to 2022 | 969 | 4,848 | 5,509 | 11,326 |
| 2022 to 2023 | 1,188 | 5,600 | 5,630 | 12,418 |
| 2023 to 2024 | 1,459 | 6,578 | 6,315 | 14,352 |
Trends in recorded alcohol and drug use
The proportion of children and young people in treatment who said they had problems with cannabis has been between 85% and 90% since 2013 to 2014. The proportion who reported having alcohol problems has been largely declining from a peak of 68% in 2008 to 2009 to 39% in 2023 to 2024.
Figure 11: trends in reported substances
The proportion of children and young people treated for ecstasy has fluctuated. It started around 10% between 2005 and 2008, decreasing to 4% between 2010 and 2012 before rising to a peak of 14% between 2017 and 2019. In 2022 to 2023, the proportion decreased to 7%, and this year it has increased again to 9%.
The proportion of children and young people in treatment for amphetamine use peaked at 12% in 2012 to 2013. Since then, there has been a trend of decreasing proportions of children and young people in treatment for amphetamine use (0.6% this year).
The proportion of children and young people in treatment for cocaine peaked in 2008 to 2009 (13%), falling to 7% in 2012 to 2013. Since this point, the proportion has remained similar year-on-year (8% in 2023 to 2024).
The proportion of children and young people reporting psychoactive substances slightly increased from the previous year to 0.8% in 2023 to 2024, following a long downward trend. Psychoactive substances were first reported in 2013 to 2014 and rose to a peak of 6% in 2015 to 2016, before falling to under 1% in 2020 to 2021 and staying at that level.
The proportion of children and young people in treatment for ketamine problems was consistently low (under 2.5%) between 2005 and 2018. However, the proportion has increased from 1.3 % in 2016 to 2017, to 8.4% in 2023 to 2024, an increase of 7 percentage points over 7 years, with the largest increase of 2.6 percentage points in the last year.
The proportion of children and young people who reported benzodiazepines as a problematic substance was also consistently low (under 1.5%) between 2005 and 2017. From 2018 to 2019 to 2021 to 2022, it was consistently over 2.5%, but this year the proportion has decreased to 1.5%.
The proportion of children and young people seeking help for heroin has remained stable and under 0.5% since 2017 to 2018.
The number of children and young people in treatment for solvent and inhalant misuse, which includes nitrous oxide, continued to increase sharply this year. It rose from 329 (2.9%) children and young people reporting a problem in 2021 to 2022, to 629 (5.1%) in 2022 to 2023, and to 881 (6.1%) this year.
The data tables for this year’s children and young people’s alcohol and drug treatment statistics also contain trends by the primary substance. This is the main problem substance that the child or young person reported when they entered treatment.
Figure 12: trends in amphetamine, cocaine and ecstasy misuse
Figure 13: trends in ketamine, solvents and inhalants, benzodiazepines and psychoactive substances
Background and policy context
Background to the data
This report presents statistics on the availability and effectiveness of children and young people’s alcohol and drug treatment in England and the profile of those accessing treatment.
The statistics in this publication come from analysis of the National Drug Treatment Monitoring System (NDTMS). The NDTMS collects data from sites providing structured alcohol and drug interventions to children and young people in every local authority in England.
The data collected includes information on the demographics and personal circumstances of children and young people receiving treatment, as well as details of the interventions delivered and their outcomes.
You can find more details on the methodology used in the report in the NDTMS annual statistics quality and methodology information paper.
Policy context
Alcohol and drug treatment in England is commissioned by local authorities using the public health grant. They are responsible for assessing local need for treatment and commissioning a range of services and interventions to meet that need.
Public health grants to local authorities: 2023 to 2024 makes it clear that:
A local authority must, in using the grant: have regard to the need to improve the take up of, and outcomes from, its drug and alcohol misuse treatment services, based on an assessment of local need and a plan which has been developed with local health and criminal justice partners.
OHID works with local authorities and provides them with bespoke data, guidance, tools and other support to help them commission services more effectively.
Guidance for alcohol and drug treatment is available in the Alcohol and drug misuse prevention and treatment guidance collection.
A wide range of NDTMS data is available on the NDTMS website, including some data reports that are only available to local authority commissioners (with a username and password).
The effect of the COVID-19 pandemic
Previous reports have noted the effect of the COVID-19 pandemic on children and young people’s drug and alcohol treatment services. In 2020 to 2021, most services had to restrict face-to-face contact, which affected the types of interventions that service users received. The COVID-19 pandemic and its effects might have affected the data in this report.
Enquiries or feedback
If you have any enquiries or feedback about these statistics, please email [email protected].