The lack of funding and attention to the needs of young people who use drugs has resulted in a situation where we lack concrete data on the extent of drug use amongst children and adolescents, and we know very little about the diverse experiences of young people around the world.
On Monday, at a session I was chairing at the International Harm Reduction Conference in Vilnius, presenters from Romania, Kenya, Nepal and from Alliance Linking Organisation, Rumah Cemara in Indonesia, shared their personal and programming experience of drug use amongst young people. They highlighted many common issues: children hidden within harm reduction services due to age restrictions and the common fears around asking and documenting age, legal systems that criminalize children as young as 8 years for drug use but deny them harm reduction services until they are 18 years, and service providers poorly prepared to work with young people, running existing programmes that don’t meet their needs.
Ioana Tomus from ALIAT in Romania reflected on the rallying cry from the International Network of People who Use Drugs (INPUD) in the conference opening session. ’Nothing about us without us’ was what they said. However, the reality for young people is that they are excluded from decisions about programme design, and there is a lack of data on harm reduction among young people. This leaves them facing a situation of ‘everything about us without us.’
Bikash Gurung from Nepal shared stories of his drug use from early adolescence and his later imprisonment for possession of small quantities of drugs. What kind of system punishes a child for drug use by incarcerating them in an adult prison? The message of the Alliance-supported campaign ‘Support. Don’t punish‘ is as critical for these young people as it is to the adult drug using community.
All of the speakers spoke of the limited capacity within organisations to engage young people and therefore tailor services for them. Perhaps it is because we find the reality of children and adolescents using drugs too difficult to face, or because supporting young people to use drugs more safely seems irresponsible and contrary to the values of protecting children? Whatever the reason, practitioners are not asking young people what they want, they are not informed about the types of drugs or the patterns of use in their communities of young people, and they seem paralysed by the ethical dilemmas and conflicting values about what it might mean to be providing 13 year olds with clean needles.
But so many rights are being denied while we make up our minds on these issues. We need to know so much more about young people and their drug use and we need to grapple with the challenging dilemmas that face us. We need to recognise the diversity of young people who use drugs – different ages, different contexts, different genders, different drugs. We have to find ways within existing legal frameworks, good or bad, to ensure we listen and respond. We need to challenge collectively the systems that continue to deny young people access to evidence based interventions based on age but not only with global policies and guidance.
Instead we must face the problems head on. We must listen to young people, find the missing data, face the unpalatable truth about the extent of drug use and the systems that violate their rights. We need to confront the uncomfortable choices to ensure young people have access to the information and services they need and respect, support and protect their ability to make decisions. Easy to say and so much harder to do, but we are going nowhere unless we do so.