Treatment for substance use problems among young offenders: difficulties and dilemmas for implementation and evaluation in the UK

Youth offending is assumed in part to be caused by substance use problems, consequently policy and practice in youth justice emphasise their treatment. We review four types of difficulty for substance use treatment of the under-18s and of youth offending team clients, then consider what might work. (1) Working with children raises systemic and ethical issues that complicate intervention and evaluation. (2) Assessing or diagnosing substance use problems in this age group is inherently problematic and often neglects the systemic aspects of pathways to treatment. Ineffective treatment may seem effective because change has occurred naturally with time. (3) Defining realistic and acceptable long-term outcomes for substance use in this age group is problematic.