Substance abuse 

Substance abuse, which includes alcohol consumption and injection drug use, is a growing area of public health concern globally among youth.

United Nations Office of the Secretary General Envoy on Youth: #YouthStats Substance Abuse.

This face sheet highlights key global evidence for youth and substance abuse in three areas: tobacco use, alcohol abuse, and drug use. (No Dates)

World Health Organization: Psychoactive Substance Use Among Adolescents.

This website houses regional fact sheets on the use of “psychoactive substances among 13-15 year old students were created for the WHO African Region and the WHO Region of the Americas. The fact sheets present data from GSHS surveys carried out between 2004 and 2009.” (2009)

United Nations – Youth and Substance Abuse

This United Nations’ page houses information and links on substance abuse and youth. (No Date)

Alcohol Consumption

Alcohol consumption among young people can lower inhibitions and contribute to higher rates of certain risky sexual behavior. For example, adolescents who use alcohol are approximately three times less likely to use condoms. Alcohol use also is associated with an increased chance of both experiencing and perpetrating sexual violence. These factors all place young people who use alcohol at a greater risk of unplanned pregnancy and of contracting HIV and other STIs. Alcohol also contributes to an increased risk of mental health problems, alcohol dependency, and alcohol-related injuries from motor vehicle accidents, falls, burns, and drowning.

An estimated 10–20% of the violent deaths among young people are estimated to be alcohol related. The rate of alcohol use among young people is unclear because data is scarce and patterns of use vary by geographical location. Heavy drinking tends to be greater among adolescents under stress and is especially high among street youth. Parents, peers, cultural and gender norms and expectations, and structural aspects such as the legal age of drinking, all influence consumption of alcohol use among youth. The most common programmatic responses to addressing alcohol use are education programs and substance abuse treatment programs. Unfortunately, there are few such programs specifically targeted at young people.

World Health Organization: Global status report on alcohol and health 2018

“This report presents a comprehensive picture of how harmful alcohol use impacts population health, and identifies the best ways to protect and promote the health and well-being of people. It also shows the levels and patterns of alcohol consumption worldwide, the health and social consequences of harmful alcohol use, and how countries are working to reduce this burden.” It has emphasis and data on alcohol patterns among youth ages 15 to 24. (2018)

Systematic Review and Meta-analysis: Prevalence of Alcohol Use Among Young People in Eastern Africa

This articles summaries the main findings of a systematic review and meta-analysis of published studies of alcohol use among young people (age 15–24 years) in eastern Africa, conducted to estimate prevalence of alcohol use and determine the extent of use of standardised screening questionnaires in alcohol studies (2014).

Alcohol Use and Sexual Risk Behaviour: A Cross-Cultural Study in Eight Countries 

WHO is initiated and coordinated this comprehensive process of developing a methodology to study factors related to risky sexual behaviour among alcohol users in diverse cultural settings. The project focused on eight countries from four continents (Belarus, India, Mexico, Kenya, Romania, the Russian Federation, South Africa and Zambia) and consisted of (1) a literature review carried out during 2002; (2) developing methodological premises for a field study aimed at complementing the literature data with up-to-date empirical findings (2002); (3) on-site research in the eight countries, yielding eight country reports (2002/2003); and (4) country-specific findings, which are the subject of this report (2005).

Global Status Report: Alcohol and Young People

Although somewhat dated, this report is a compilation of data from WHO's global alcohol database. This report provides an overview of the prevalence of drinking among young people, alcohol-related mortality and other health effects, trends in the alcohol environment surrounding youthful drinking, and prevention policies designed to reduce alcohol-related problems among the young (2001).

Injection Drug Use

While a lack of reliable data on injecting drug use among youth makes it challenging to firmly establish the numbers of youth affected, research suggests that injecting drug use is a significant source of HIV infection among youth in some regions (particularly the Middle East, North Africa, Asia, and Latin America). Yet most drug treatment services cater to adults or addicts, and the needs of young injecting drug users (IDUs)—especially those in the early stages of injecting or those who do not consider themselves addicts—are often overlooked. 

Most IDUs start the practice when they are young. Motivations for the first injection are similar across cultures. Curiosity, peer pressure, and availability are key factors. First injections rarely occur alone; they usually take place in a social situation, with a young person injected by a friend, relative, or sexual partner. Many young IDUs are involved in the sex industry and report multiple sexual partners and unprotected sex. Young people who inject drugs are often unaware of risks associated with their behavior, including the severity of health problems they may encounter. Since drug use is illegal and often stigmatized, young IDUs tend to avoid mainstream society and vice versa.

The WHO strongly recommends that a ‘harm reduction’ approach be adopted with all IDUs, including vulnerable youth, that includes a defined and comprehensive package including:

  • Needle and syringe programs
  • Drug dependence treatment (particularly opioid substitution therapy
  • HIV testing and counseling
  • HIV treatment and counseling
  • Information, education and risk reduction counseling
  • Condom distribution and STI management
  • Management of TB and viral hepatitis

In addition, programs focused more specifically on youth should focus on prevention and minimizing risk while acknowledging that most IDUs among youth are occasional users.

  • Preventing HIV by discouraging young people from initiating injecting drug use
  • Reducing risks of HIV associated with injecting drug use (i.e., "harm reduction")
  • Address other challenges facing youth, including employment, abuse, and social isolation

Excluding Youth? A Global Review Of Harm Reduction Services For Young People.

“The chapter begins by outlining recent trends in IDU among young people. As part of the Global State of Harm Reduction 2012 survey, new international data were collected from civil society and researchers, and this chapter reports our analyses of these data to provide a unique and timely study of legal age restrictions and other barriers to young people accessing harm reduction services. This chapter also highlights case studies of best practice for meeting the needs of this population in different settings, to inform our recommendations for improving policies and services to reduce drug-related harm.” (No Date – likely 2013)

HIV and Young People who Inject Drugs: A Technical Brief

This technical brief summarizes the state of knowledge on injecting drug use among youth with a focus on its implications for HIV. The report reviews the knowledge on prevalence of IDU among youth, programmatic responses that have shown promise, a section specifically on young women, and recommendations for program and policy going forward (2015).

Injecting Drug Use Among Under-18s: A Snapshot of Available Data

This report, published as a part of Harm Reduction International’s series, “The Global State of Harm Reduction,” attempts to compile all available data on IDU by children (under age 18). The report highlights the lack of data at both the country and global levels for this age group, reviews available data by region, and suggests recommendations for national governments, researchers and multilateral organizations (2013).

A Young Peer Trainer’s Guide to Provide Sexual Health and Drug-Related Harm Reduction Education 

This guide is based on training given by youth in Mexico, Canada, Romania, and India as a part of the RISE UP program, and provides young people with much needed free access to training resources about HIV/AIDS, substance use, and sexual health. More specifically, the guide includes basic information about HIV/AIDS and drug use; strategies for reducing sexual and drug-related harms; and issues related to the stigma and discrimination that often accompany particular sexual behaviors and drug use. The project was funded by MTV Staying Alive Foundation.