SECTION 1 SECTION 2 SECTION 3 Drug type Living Situation General Health 2 Alcohol 0 No problems with accommodation 0 Young person reports no significant health problems 2 Amphetamine 1 Problems with accommodation, insecure, or 1 Teeth problems inadequate housing 2 Cannabis 2 Looked after by Local Authority 1 Stomach Problems 4 Cocaine 6 Homeless 1 Regular headaches 4 Crack 1 Difficulty sleeping 4 Ecstasy Adult Support 5 Chronic fatigue 4 Heroin 0 Has supportive relationships with more than one adult 5 Severe sleep problems 4 LSD 1 Has supportive relationship with one adult 5 Self neglect 4 Magic Mushrooms 2 Has no supportive relationships with adults 10 Extreme weight loss 4 Solvents / Gas / Aerosols 10 Blackouts and / or memory loss 2 Other Please list (including misuse of Occupation 10 pregnant – prescribed drugs). Score 2 each Drug/Alcohol use - Frequency 0 In education / employment / training 10 Fitting 1 Occasional drug / alcohol use 1 Truanting from school / at risk of school exclusion / 10 Accidental / planned overdose drug or alcohol related absences from work 2 Regular drug / alcohol use 2 School excluded / unemployed Injection Criminal Involvement Psychological Heath 0 Not Injecting 0 No criminal involvement 0 Young person reports no significant 5 Currently / Recently injecting 1 At risk of involvement in the criminal justice system 1 Low self esteem Drug / Alcohol Use - Intoxication 2 Involved in criminal justice system or committing more 1 Mild anxiety more serious crimes 0 Drug/ Alcohol use without loss of Sexual Behavior 1 Shyness consciousness or aggression 2 Drug / Alcohol use with loss of 0 Age appropriate / safe sexual behavior 5 Eating disorder / marked change in eating consciousness or aggression pattern (e.g loss of appetite / binging) Contact with Other Drug / Alcohol Users 2 Inappropriate / unsafe sexual behavior 5 Frequent bouts of unhappiness / depression 0 No Drug / Alcohol friends 6 Commercial sex / abusive sexual relations 5 Self harm 1 Some friends who use drugs / alcohol 5 Severe anxiety / panic attacks and some who don’t 2 All friends use Drug / Alcohol 10 Suicide attempts Family Drug / Alcohol Use 10 Severe paranoia 0 No known family drug / alcohol misuse 10Hallucinations (when not under the influence) 2 Known drug / alcohol misuse among TOTAL SECTION 1: close family member(s) / careers 5 Significantly affected by someone TOTAL SECTION 2: TOTAL SECTION 3: else’s drug / alcohol misuse
SECTION 1 SECTION 2 SECTION 3 Drug type Living Situation General Health 2 Alcohol 0 No problems with accommodation 0 Young person reports no significant health problems 2 Amphetamine 1 Problems with accommodation, insecure, or inadequate housing 1 Teeth problems 2 Cannabis 2 Looked after by Local Authority 1 Stomach Problems 4 Cocaine 6 Homeless 1 Regular headaches 4 Crack 1 Difficulty sleeping 4 Ecstasy Adult Support 5 Chronic fatigue 4 Heroin 0 Has supportive relationships with more than one adult 5 Severe sleep problems 4 LSD 1 Has supportive relationship with one adult 5 Self neglect 4 Magic Mushrooms 2 Has no supportive relationships with adults 10 Extreme weight loss 4 Solvents / Gas / Aerosols 10 Blackouts and / or memory loss 2 Other – Please list (including misuse of prescribed drugs). Score 2 each Occupation 10 pregnant Drug/Alcohol use - Frequency 0 In education / employment / training 10 Fitting 1 Occasional drug / alcohol use 1 Truanting from school / at risk of school exclusion / drug or alcohol related absences from work 10 Accidental / planned overdose 2 Regular drug / alcohol use 2 School excluded / unemployed Injection Criminal Involvement Psychological Heath 0 Not Injecting 0 No criminal involvement 0 Young person reports no significant 5 Currently / Recently injecting 1 At risk of involvement in the criminal justice system 1 Low self esteem Drug / Alcohol Use - Intoxication 2 Involved in criminal justice system or committing more more serious crimes 1 Mild anxiety 0 Drug/ Alcohol use without loss of consciousness or aggression Sexual Behavior 1 Shyness 2 Drug / Alcohol use with loss of consciousness or aggression 0 Age appropriate / safe sexual behavior 5 Eating disorder / marked change in eating pattern (e.g loss of appetite / binging) Contact with Other Drug / Alcohol Users 2 Inappropriate / unsafe sexual behavior 5 Frequent bouts of unhappiness / depression 0 No Drug / Alcohol friends 6 Commercial sex / abusive sexual relations 5 Self harm 1 Some friends who use drugs / alcohol and some who don’t 5 Severe anxiety / panic attacks 2 All friends use Drug / Alcohol 10 Suicide attempts Family Drug / Alcohol Use 10 Severe paranoia 0 No known family drug / alcohol misuse 10Hallucinations (when not under the influence) 2 Known drug / alcohol misuse among close family member(s) / careers TOTAL SECTION 1: 5 Significantly affected by someone else’s drug / alcohol misuse TOTAL SECTION 2: TOTAL SECTION 3:
cse-resources_11_1688452746.docx