Prevention must be the foundation of the world’s response to the menacing spread of drug addiction. The growing costs of drug use are staggering. The difficulty of stopping drug use by those already addicted to drugs is unmistakable. Virtually all adults with substance use disorders began using substances before age 18, and it is well-known that the earlier the initiation to use and the heavier that use, the more likely an individual will suffer problems related to substance use later in life. Initiating problematic substance use in adulthood is far less common. In the context of youth drug use, this includes drugs that are legal for adults in most parts of the world, including alcohol and nicotine, and sometimes marijuana, as well as the purely illegal drugs such as cocaine, heroin and the new psychoactive substances (NPS).
Across the world, most youth do not use any substances. The imperative public health goal today worldwide is to increase the percentage of children and young adults who make the choice for health not to use any drugs. Achieving this goal will shrink the number of young people who develop substance use disorders in adulthood. While adult substance use can be controversial, youth substance use is universally seen as unhealthy and unwise.
Modern brain science has shown the unique vulnerability of the developing brain to addictive drugs as well as the great risk of youth substance use progressing to addiction. Research shows that often for youth, decisions about substance use are not drug-specific. Once a young person has used any substance, there is a significantly increased risk of that young person using other substances. The critical health decision for every young person is whether to use or not to use any substances. Those who choose to use substances go on to face a thousand additional decisions, day in and day out, about which drugs to use, when and how much to use. Those who choose not to use any substances have no such decisions with which to struggle. Youth prevention must therefore focus on that core decision, understanding that across the world different drugs are more common than others.
The world must unite in promoting a clear health standard for the health of our youth: no use of substances including alcohol, nicotine, marijuana and other illicit drugs. This is analogous to other clear health standards like wearing seat belts in vehicles, healthy eating habits and daily exercise. Some youth do use drugs. This same health standard applies to them: encourage and support them in stopping their substance use. To normalize youth drug use is to put youth at risk of the many harms that result from drug use in both youth and adulthood. To de-normalize youth drug use is to protect the health of youth and to reduce the problems of adult drug use.
This health standard of no use for youth is central to Article 33 of the Convention on the Rights of the Child (CRC), the only UN convention that specifically addresses youth drug use. It states, “States Parties shall take all appropriate measures, including legislative, administrative, social and educational measures, to protect children from the illicit use of narcotic drugs and psychotropic substances as defined in the relevant international treaties, and to prevent the use of children in the illicit production and trafficking of such substances.”
Embracing CRC Article 33, and the science of the uniquely vulnerable developing adolescent brain, nations from across the world must unite around the health standard of no use for young people and work directly with youth to greatly increase that number who choose to not use any substances.
Written by Robert DuPont, Board Member representing North America.