Excluding Youth?

A global review of harm reduction services for young people

Aim of the Chapter

• To provide a global snapshot of the harms experienced via injecting drug use (IDU) among young people aged under 18 and existing harm reduction responses targeted at this population

Young people and drug use

• Overall levels of drug use amongst young people appear to be stabilising or decreasing in many high-income countries

• Low and middle income countries in Eastern Europe, Asia, Africa and South America- a ‘historic high’ in youth drug use and spreading to new regions (eg. Africa)

Young IDU and vulnerability to harm

• Lack knowledge and have misconceptions about HIV transmission

• HIV transmission due to unsafe injecting and criminalisation of these behaviours

• Young people often first to experiment with new substances and highly connected to dense drug supply networks

Current response and data gaps

• Dominance of prevention and punishment responses

• Lack of youth-focused harm reduction services• Age restrictions on harm reduction services• Lack of youth participation

Age restrictions

• 85 countries reporting at least one NSP or OST, and data on the existence of age restrictions available for 77 countries

• Of these, 18 countries reported age restriction for accessing NSPs and 29 for accessing OST

• Other barriers include: parental consent requirements, evidence of previous failed attempts at detoxification or other drug treatment, ‘aiding and abetting’ laws

Regional overview

• Common themes that restrict access to services for youth globally:– Age restrictions– Stigma– Criminalisation– Lack of data on young IDU– Lack of youth-focused programmes

• Case studies: – Opening Doors– TRIP!

Priority areas moving forward

• Avoid legal age restrictions• Youth-led, youth-friendly harm reduction• Improving data collection• Investment in young people most at risk• Structural interventions- the holistic approach