This informal CPD article ‘Substance Misuse in Children’s Residential Care: Trauma-Informed Responses and Safeguarding Responsibilities’, was provided by Rachel Webb of Phoenix-Kaw Care Consultancy, a health and social care training and consultancy organisation dedicated to improving standards of care across the sector.
Substance misuse among children and young people remains a significant safeguarding concern within residential childcare services (1) (2). Young people may misuse alcohol, illegal drugs, prescription medication, solvents or nicotine products for a variety of reasons including trauma, peer pressure, emotional distress, exploitation, family difficulties, social isolation or poor mental health. Residential childcare practitioners are increasingly supporting children affected by substance misuse, county lines activity, criminal exploitation and emotional dysregulation linked to addiction or dependency.
Children living in residential care are often particularly vulnerable because many have experienced abuse, neglect, adverse childhood experiences, attachment disruption or unstable family relationships. Substance misuse may become a coping strategy for managing emotional pain, anxiety, low self-esteem or unresolved trauma. Understanding the reasons behind harmful behaviours is essential for providing effective and compassionate support.
Understanding Substance Misuse
Substance misuse refers to the harmful or inappropriate use of alcohol, drugs, medication or other substances that negatively affect physical health, emotional wellbeing, behaviour, relationships or daily functioning. Young people may experiment with substances due to curiosity or peer influence, but repeated misuse can quickly lead to dependency, exploitation, criminal behaviour or serious safeguarding concerns (1) (3).
Adolescents are more vulnerable to risk-taking behaviours because the areas of the brain responsible for impulse control, decision-making and emotional regulation are still developing (4). This means young people may struggle to fully understand the consequences of their actions or recognise dangerous situations. Residential care staff must therefore respond with professional curiosity, consistency and trauma-informed approaches rather than punishment alone.
The Misuse of Drugs Act 1971 outlines drug classifications, offences and legal responsibilities relating to controlled substances (7). Residential childcare providers must understand their safeguarding duties when substance misuse is identified and ensure concerns are reported appropriately.
Safeguarding Risks Linked to Substance Misuse
Substance misuse can place children and young people at increased risk of exploitation, criminal involvement, self-harm, missing episodes, violence and mental health crises. County lines activity has become a growing concern within residential childcare services, with organised criminal groups targeting vulnerable young people to transport drugs or money across different areas (5) (6).
Children affected by exploitation may display changes in behaviour such as secrecy, aggression, missing from care episodes, possession of unexplained money or gifts, declining mental health or disengagement from education. Staff should remain alert to safeguarding indicators and work closely with police, social workers, schools and specialist substance misuse services.
Substance misuse can also negatively affect relationships, physical health and emotional stability. Some young people may experience anxiety, depression, paranoia, overdose risks or suicidal thoughts linked to drug or alcohol misuse. Early intervention and multi-agency working are therefore essential.
Trauma-Informed and Therapeutic Responses
Trauma-informed practice recognises that behaviour is often linked to past experiences rather than deliberate defiance. Children who misuse substances should be supported with empathy, consistency and therapeutic interventions that focus on understanding underlying needs.
Residential childcare practitioners should build trusting relationships, provide emotional support and encourage healthy coping strategies. This may include access to counselling, mental health support, education around substance misuse, restorative conversations and positive activities that build confidence and resilience.
Clear boundaries and safeguarding procedures remain important, but responses should avoid shame or stigma. Children are more likely to seek help when they feel safe, listened to and supported by trusted adults.
Conclusion
Substance misuse in residential childcare settings is a complex safeguarding issue that requires compassion, professional curiosity and trauma-informed responses. Residential childcare practitioners have an important role in recognising risks, protecting vulnerable young people and supporting recovery through positive relationships and multi-agency collaboration. By creating safe and supportive environments, professionals can help children build resilience, improve wellbeing and reduce the long-term risks associated with substance misuse.
We hope this article was helpful. For more information from Phoenix-Kaw Care Consultancy, please visit their CPD Member Directory page. Alternatively, you can go to CPD Industry Hubs for more articles, courses and events relevant to your Continuing Professional Development requirements.
References
(1) NICE (2016) Coexisting Severe Mental Illness and Substance Misuse. Available at: www.nice.org.uk
(2) Ofsted (2023) Social Care Common Inspection Framework (SCCIF). Available at: www.gov.uk/government/publications/social-care-common-inspection-framework-sccif
(3) Public Health England (2021) Young People and Substance Misuse. Available at: www.gov.uk/government/organisations/public-health-england
(4) Royal College of Psychiatrists (2020) Adolescent Brain Development. Available at: www.rcpsych.ac.uk
(5) The Children's Society (2022) County Lines and Criminal Exploitation. Available at: www.childrenssociety.org.uk
(6) Contextual Safeguarding Network (2021) Exploitation Indicators Guidance. Available at: www.contextualsafeguarding.org.uk
(7) Misuse of Drugs Act 1971. Available at: www.legislation.gov.uk/ukpga/1971/38
