G153 THE DEVELOPMENT OF A MULTIAGENCY SERVICE FOR YOUNG SUBSTANCE MISUSERS
L. Light, B. Singh. South Staffordshire Health Authority, UK
Aims: Level 3 is a two-year project testing the feasibility of delivering a substance misuse service for young people under 18 on a multiagency basis. The project was funded by a Health Authority and was a partnership between an NHS Trust and a specialist alcohol advisory service. The aim was to interlock specialist drug services with mainstream young peoples services to provide holistic care.
Methods: Referrals were invited from February 1999 from statutory and voluntary agencies as well as self-referrals from young people and their families. Two project workers were appointed and consultant paediatrician and child psychiatry sessions were funded. All project policies were approved by the ACPC. Substitute prescribing and screening for Hepatitis B, C and HIV was offered as needed. Immunization for Hepatitis B was offered as well as screening for STDs, dental checks or other tertiary referrals.
Results: 79 referrals were received between February 1999 and March 2000 resulting in 450 client appointments. 79% clients were male and 46% were for heroin abuse. 90% clients reported a reduction in substance misuse and an improvement in physical health and 80% reported a reduction in criminal activity with a 50% reduction in health risk behaviour.
Conclusions: This innovative service is having a considerable impact in meeting the needs of young people with problematic substance misuse, their families and other service providers. Further development to meet the growing number of referrals is now needed.
G154 AUDIT OF AN ADHD CLINIC--ESPECIALLY RELATING TO EFFECTIVE MANAGEMENT OF EARLY ONSET OPPOSITIONAL DEFIANT DISORDER/CONDUCT DISORDER--2000
G.D. Kewley. Learning Assessment Centre, W. Sussex, UK
Specialising in the multidisciplinary assessment/management of children and adolescents with neurodevelopmental and learning problems especially ADHD and related conditions, The Learning Assessment Centre audits its 3,000 patients. Case notes of 106 patients were clinically reviewed. 10% had conditions other than ADHD and 10% of those with ADHD were not medicated, at least initially. Average age of presentation was 10-11 years.
ADHD core symptom breakdown at diagnosis was as follows:
* 64% Combined ADHD--most had Hyperkinesis.
* 12% Met combined ADHD criteria when younger--hyperactivity had gradually diminished with time--still impulsive and inattentive.
* 14% Predominantly inattentive.
* 10% Predominantly inattentive and impulsive--(never been hyperactive).
64% had combined ADHD and of these 57% had associated early onset ODD and/or CD. 73% of this latter group were not adequately treated by Ritalin or Dexedrine alone, and required a second medication to achieve a 92% very positive outcome. Usually clonidine was used, sometimes fluoxetine or risperidone. With a second medication, parents/teachers of children reported significant additional benefit of reduced oppositional/ conduct problems, not obtained by the sole use of a stimulant.
Audit data is consistent with research findings that ADHD may be associated with early onset ODD and Conduct Disorder, and thus to...