1. Excluding Youth?
A global review of harm reduction
services for young people

2. 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

3. 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)

4. 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

5. 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

6. 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

7. 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!

8. 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