Suzanne Hare and Dee Stanford work at Cambridgeshire and Peterborough NHS Foundation Trust. This presentation for the ADEPIS seminar on NPS - held on Monday 19th May - is intended to explore local treatment procedures for NPS users.

1. CASUS
Cambridgeshire Child
and Adolescent
Substance Use Service
Suzanne Hare &
Dee Stanford

2. CASUS delivers:
• Information, advice to young people
• Advice and support to parents / carers or someone affected by another
person’s drug or alcohol use.
• Training, support and consultancy to professionals working with young
people.
• Support for PSHE in schools and alternative education settings.
• Sessions for groups of young people at risk and in vulnerable
situations.
• Specialist treatment drug and alcohol treatment for young people, which
include psychosocial interventions, family work, harm reduction and
specialist prescribing.

3. Referral Process
• A parent/ carer or professional can refer
• Self referrals
• The young person must consent to referral for treatment.
• Phone call 01480 415 278
• CASUS Referral form / letter or CAF ( not via SPA at present)
• Confidential advice and information for parents and carers is
available from CASUS .
• www.casus.cpft.nhs.uk casus@cpft.nhs.uk

4. What is happening in Cambridgeshire?
Health Related Behaviour Survey
Professor Balding, Exeter University
2002- 2012
Little or no mention of NPS
What will 2014 show??

5. Good News
2011-2012 NTA data tells us…
1) The number of under 18s accessing
specialist services for substance misuse
in England fell to 20,688 (figure peaked
at 24,053 in 2008/2009)
2) The number of young people being
treated primarily for class A drugs (such
as heroin and cocaine) has fallen by two
thirds from 5 years ago
3) Alcohol and Cannabis remain by far the
main substances for which under 18s
access specialist services in England
(92%)
4) NPS. Very small numbers but data
capture methods poor.

6. SUD
No - SUD
10yrs 20 yrs
Experimentation and SUD

7. Not so good news
• The rise of Poly-pharmacy (“living in the sweet shop...”) – a chemical universe-
new substances abound.
- The National Poisons Information Service 2012/13 report notes a
49% increase in telephone enquiries and 128% increase in
TOXBASE accesses relating to nps
• Early (< 16 yrs) exposure to (particularly with early positive self-evaluations)
drugs such as cannabis -> associated with poorer prognosis, such as adult
dependency (Fergusson et al 2003).
• Those young people who do use substances are starting younger, using more,
and using stronger varieties

8. Novel Psychoactive Substances
Legal status: legal, Temporary Class, ABC
Cost: various
Effects: stimulant, depressant, hallucinogen
Risk: poisoning, there is no historic data on effects, they are very difficult to treat
in A&E, symptomatic relief in only, long term effect are mostly unknown

9. NPS Treatment
• A&E and GPs treat the majority of acute harms
arising from NPS
• Routine management of intoxication and poisoning
evidence of treatment adaption for NPS
- “mimic illicit drugs but stronger and potentiated by alcohol etc”
• Challenging to provide information and guidance
for those seeking healthcare but wish to continue
to use NPS.
“a new substance every 6 days “ “ mxe OTS” AAPG Drug Strategy

10. Early Findings from UK’s First National Online
Survey of Users of New Psychoactive
Substances (Legal Highs)
• “legal and therefore safe”
- main driver for use – “illusion of safety”
• belief that health consequences are mild and will
not require treatment.
• “have I broken the law?”

11. CASUS Treatment Model

12. NPS CASUS Treatment
• Primary drug for Rx remains cannabis and alcohol
• NPS identified in taking of Drug Hx
• Immediate harm reduction messages
- Overdose, poisoning,
- Hep B
- Drug interaction
• Psycho-education
• Explicit with ‘our concerns’ (heroin, solvents, NPS)
• MI to address higher ambivalence
• Treatment as usual, including co morbidity

13. Web: www.casus.cpft.nhs.uk
Youtube: CASUStv
Twitter: casus_cpft
Email: casus@cpft.nhs.uk
Phone: 01480 415278