Children: Global Victims of Drug Abuse

Article by Maria Larsson, Minister for Public Health, Sweden and Robert DuPont, M.D., USA

One of the most tragic and overlooked consequences of the modern drug abuse epidemic is the price paid by children for adult drug use. While some apologists for illegal drug use claim it is a “victimless” behavior, our work with children on both sides of the Atlantic tell a starkly different story.

The modern drug abuse epidemic hit both Sweden and the United States with great force in the late 1960s. While many drugs had been around for centuries, what was new was the widespread use of many dependence-producing drugs in the populations by the most potent routes of administration, especially smoking and intravenous injection. Only in the last two decades has modern brain science – with both Sweden and the U.S. taking a lead – demonstrated how drugs work by hijacking the brain’s natural reward system to produce addiction, leading to medical, social and mental problems that are often life-long. The global challenge of public health today is to develop effective strategies to limit the nonmedical use of the currently illegal drugs – including cannabis, methamphetamine, cocaine and heroin – using programs and laws that are affordable and that respect human rights and the compassionate values of modern culture.

Adolescents are the most likely age group to initiate substance use. Of the 2.9 million Americans in 2008 who initiated drug use, 56.7% (1.64 million) were younger than 18 years old. In Sweden, in 2009, 18% of 18-year old students reported lifetime use of an illicit drug but only 3% had used more than ten times. With the human brain still developing until age 25. drug use is a dangerous threat, particularly as drug use peaks from ages 18 to 35. This indicates that not only must primary prevention focus on children in the teenage years, but also that many of the most serious adverse effects of drug use occur in parents of young children.

Nearly 12% of all children living in the United States (8.3 million) have lived with at least one substance-dependent or substance-abusing parent in the last year; the majority of these children were under 12 years of age. Between 1.2% and 1.8 % of all children in Sweden, are estimated to live in families where at least one parent has used cannabis the last year. It is of the highest priority to seek knowledge about this problem and to reach out to these children with help and support.

While a combination of environmental and genetic factors plays a role in the initiation of substance abuse. abused and/or neglected children of substance-dependent or abusing parents are at greater risk for future substance use. The need to detect persons and families with substance abuse, abuse before the onset of health and social consequences for their children, is essential in all preventive work. Early support and interventions directed at children in families with drug problems can help avoiding future learning problems in school, social marginalization and drug use. Non-governmental organizations play a crucial role in this work, both in the U.S. and in Sweden.

Around the world there have been a number of lobbying campaigns to allow possession and use of illegal drugs. Different efforts with this purpose have been obvious not least at the meetings of the UN Commisison on Narcotic Drugs in Vienna. As a result, we can see countries or cities which allow injection rooms, legal prescription of heroin and other drugs that are misused. The development in Sweden’s neighbouring countries, Denmark and Norway, could also have a direct impact on the Swedish situation. In the worst case, this development can also contribute to increased drug use and more liberal attitudes in Sweden.

Most worrysome is the global lobbying to downsize the danger of cannabis use, spreading information that the use of cannabis is harmless. There are also proposals to allow smoked cannabis for medical use. Some argue this is good for the economic growth. If this lobbying suceeds, it will be the young generation that will have to pay the price.

The United Nations Convention on the Rights of the Child (CRC) is a legally binding international document that protects children’s civil, cultural, economic, political and social rights One of the most critical issues the CRC can better address is the social rights of children to be protected from adult drug abuse. The CRC Treaty specifically states that states will take measures to protect children from use, production and trafficking of illegal substances. The global challenge is to not only protect children from adult drug use but also of their own initiation of drug use. This is an essential global goal because the younger a person is when he or she uses a drug, the more malignant the consequences.

Today, and a few days forward, a few hundred delegates meet here in Stockholm to focus on the harm from narcotic drugs. This is no coincidence. Sweden has a situation where there is broad public support for a balanced and restrictive drug policy which rejects all illegal drug use. It includes prevention and treatment as well as vigorous enforcement of laws that are characterized by swift and certain but not severe penalties. This policy, built on a unique national experience with an explosive increase in illegal drug use, has enjoyed a sustained and strong national support across the broad spectrum of Swedish political life. Today it is a powerful model for the U.S. and the rest of the world as the modern drug epidemic has become a global problem.

Maria Larsson

Robert L. DuPont, M.D.