Drugs and Substance Misuse (Including Smoking)

1. Definition

Drugs and substances are defined as any substances, whether restricted or prohibited, which may have a harmful effect upon a child, such as:

Alcohol, Cigarettes, Tobacco, Aerosols, Gas, Glue, Magic Mushrooms (Amanita), Petrol, Solvents and all controlled substances such as Amphetamines, Barbiturates, Benzodiazepines, Cannabis, Cocaine, Hallucinogens, and Narcotics.

Many looked after young people use drugs for recreational reasons, just like other young people, but, there is evidence that looked after young people may use drugs, including alcohol to 'forget bad things', reflecting their difficult and traumatic personal histories.

In addition, where children and young people are abused through sexual exploitation, alcohol and other drugs are often used in the grooming and enticement process. There is a close connection between the uses of alcohol and substances as a significant factor in young people's sexual behaviour and as with other aspects of their lives, children and young people learn from the behaviour of those around them. All professionals working with looked after children should understand the referral pathways for treatment.

2. Access/Use Of Drugs And Substances

2.1 Purchasing Drugs or Substances

All reasonable measures must be used to reduce or prevent children from obtaining drugs or substances that may harm them.

If it is known or suspected that children are obtaining products that may harm them, whether off the streets, from dealers or from traders of any kind, the manager/supervising social worker and social worker must be informed and a strategy adopted to reduce or prevent it.

If the problem persists or is serious, relevant specialists or bodies, including Trading Standards or the Police, should be informed.

2.2 Cigarettes and Tobacco

It is a criminal offence for cigarettes to be purchased by or on behalf of those less then 18 years of age.

Smoking is the main cause of preventable death and the main cause of health inequalities. Helping these young people to stop smoking is the most effective and cost effective of all the interventions they receive. All professionals should be encouraged to systematically deliver very brief or brief interventions to all smokers at every opportunity, and refer into the local NHS Stop Smoking Service.

There should be an emphasis on protecting looked after children from taking up smoking and protecting them from second hand smoke as well as providing them with an environment they can grow up in where smoking is actively discouraged. Where looked after children already smoke they should be encouraged to give up. A range of support is available at NHS Choices

Staff and carers must not condone a child or young person smoking, for example by looking after their cigarettes or allowing the young person time to smoke. If children are permitted to smoke, this must have the parents' consent or, if the parents are not available, the Service Manager for LAC. The arrangements for managing the child/young person's smoking should be set out in the child's Placement Plan.

In foster homes, carers/visitors should be discouraged from smoking cigarettes or tobacco in front of children and children may not smoke inside the home.  Foster carers are not permitted to purchase or give cigarettes, tobacco or the materials for making or lighting cigarettes or tobacco to children and, as indicated above, this is a criminal offence.

In residential care, staff/visitors are not permitted to smoke in the establishment or in front of children and children may not smoke inside the home.  Members of residential staff are not permitted to purchase or give cigarettes, tobacco, or the materials for making or lighting cigarettes or tobacco to children and, as indicated above, this is a criminal offence.

2.3 Alcohol

In foster homes, the supervising social worker and the social worker for any children placed should come to an agreement with the foster carers whether alcohol may be consumed by the child.

In residential care, staff/visitors and children are not permitted to consume alcohol on duty or in the establishment and staff are not permitted to take children into licensed premises other than those with separate restaurants.

2.4 Aerosols, Gas, Glue and Petrol

Staff/carers must ensure that aerosols, gas, glue, petrol and similar substances are only used for the purpose they were designed for; and that all reasonable measures are taken to restrict their use to children who are known to pose no risk to themselves or others if they have access to them.

In foster homes, the arrangements for the obtaining, storage or access to children of these substances will be outlined in Safe Care Policy which all foster carers are obliged to adhere to.

In residential care, the arrangements for the obtaining, storage and use of these substances must be outlined in the Staff Handbook and Children's Guide.

2.5 Controlled Drugs and Substances

Under no circumstances may controlled drugs and substances, other than those prescribed by a medical practitioner, be permitted in any foster home or children's home.  See Administration of Medication Procedure in relation to the requirement to safely store prescribed drugs in children's homes

3. Prevention and Planning

All staff/carers should ensure that information, guidance and advice on the risks associated with harmful drugs and substances are available to all children looked after. Additionally, any child known or suspected to be participating in drug or substances misuse activities must be provided with the following:

• Targeted relevant information, guidance and advice to help reduce or prevent such risks as part of their Health Care Plan;
• A strategy for managing the risk, outlined in a Behaviour Management Plan, including in what circumstances the Police will be notified;
• As part of this strategy, consideration should also be given, through consultation with the child, to making referrals for specialist support and help children to access treatment, if appropriate.

4. Emergencies

If it is suspected that a child is misusing harmful drugs or substances and no strategy exists to reduce or prevent the behaviour, the child's social worker should be contacted and an agreement reached on how to proceed; this will include whether the Police will be notified.

If there are immediate risks and the social worker or manager/link worker are not available, staff/carers should take what actions are immediately necessary then inform the manager/supervising social worker and the child's social worker at the first opportunity.

The actions that staff/carers take will be dependent on the circumstances and the degree of offence or injury that is likely.

The overall responsibility of staff/carers is to protect children, themselves and others from injury and reduce or prevent the likelihood of criminal offences.

If there is a risk of serious harm, injury or of a serious criminal offence and staff/carers are unable to manage safely, the Police should be notified.

If solvents are involved, allow air to circulate freely and extinguish naked lights.

If any person is unconscious, in a fit, convulsing or otherwise seriously ill, emergency first aid should be given and an ambulance requested.  The emergency services should be informed that there are suspicions of drug or solvent misuse.

The drugs/substances should be removed or confiscated, preferably with the co-operation of the child, and preferably by two staff/carers; who must record their actions, describing what they have obtained and where it has been safely stored.

If children do not cooperate or there is a risk of injury or damage to property, it may be necessary to use Physical Intervention, conduct a search or call for Police assistance.

Also see the following procedures:

Searching Children and Their Belongings Procedure

Contacting the Police Procedure

No further action, beyond making the situation safe and attempting to confiscate harmful drugs or substances, should be taken without a manager's authorisation, preferably in consultation with the child's social worker.

However, the staff/carers should undertake the following if a manager/supervising social worker is not available within a reasonable timescale:

• Legal but potentially harmful substances such as cigarettes, alcohol, aerosols, gas, glue, and petrol should be put in a safe place out of the reach of children or disposed of safely;
• Controlled substances and any associated materials or paraphernalia must be placed in a clearly marked box or other strong container and sealed, for passing to the foster carers' supervising social worker, child's social worker or residential manager as soon as practicable.  (They must then arrange for it to be taken to a competent authority e.g. pharmacist or doctor; and a receipt obtained).

When safe to do so, the manager/supervising social worker and child's social worker should be notified and a decision reached on the actions/measures to be taken. This should include whether the Police should be notified.

5. Recording

Staff/carers should record any occurrence as outlined in this procedure in the child's Daily Record.