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Kate Iorpenda
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GET THEM
YOUNG
It’s time to overcome our paralysis
on tackling young people’s drug use,
says
Kate Iorpenda
ARTICLE 3 OF THE UN CONVENTION ON THE RIGHTS OF THE CHILD
declares
that in all actions concerning children, whether undertaken by public or
private social welfare institutions, courts of law, administrative authorities
or legislative bodies, the best interests of the child shall be a primary
consideration. With this in mind, the issue of drug use among children –
and in particular injecting drug use – is one that raises a number of ethical
dilemmas and consequent heated debate among practitioners.
Perhaps it’s because we find the reality of children and adolescents
using drugs too difficult to face. Or perhaps it’s because supporting
young people to use drugs more safely seems irresponsible and contrary
to the values of protecting children. Whatever the reason, the
comprehensive services that are available to young people in some
countries are not currently translating into service provision in poorer
countries. In such contexts we need to be asking ourselves: have we
consulted with young people to find out what they want and are we well
enough informed about the types of drugs they take and their patterns of
use? Otherwise we run the risk of being paralysed by the ethical
dilemmas and conflicting values about what it might mean to be
providing teenagers with clean needles.
Injecting drug use is a key driver of HIV epidemics in regions like
Eastern Europe and Central and South East Asia, and the little available
data we have indicates that in some countries children start injecting at a
very young age. 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 their drug use. However we do know that children
with histories of abuse, mental health problems, and drug dependence in
the family are among those at higher risk.
Adults have rights and choices about services and can be helped to
seek other support – counselling, debt advice, housing – but with
children there is a duty of care, and so service providers need to think
both about safeguarding that duty of care and about how far it
extends, given the complex and multiple needs of many young people
who inject drugs.
Children and young people are often hidden within harm reduction
services due to age restrictions and fears around asking and documenting
age. In some countries, legal systems criminalise children as young as
eight for drug use but deny them access to harm reduction services until
they are 18. Additionally, service providers are often poorly prepared to
work with young people, running programmes that don’t meet their
needs and which have been designed without their input.
What kind of system punishes a child for drug use by incarcerating
them in an adult prison? So many rights are being denied while we
make up our minds on such issues. We need to know so much more
about young people and their drug use and to recognise the diversity
involved: different ages, different contexts, different genders, different
drugs. We have to find ways within existing legal frameworks, good or
bad, to ensure that we listen and respond. We need to collectively
challenge the systems that continue to deny young people access to
evidence-based interventions because of their age, but we also need to
go beyond global policies.
Instead we must face the problems head on and listen to young
people, find the missing data, face the unpalatable truth about the extent
of their drug use and the systems that violate their rights. We need to
confront uncomfortable choices to ensure that young people have access
to information and services that they need and respect, and to support
and protect their ability to make decisions. Easy to say and so much harder
to do, but we are going nowhere unless we get over our paralysis.
Kate Iorpenda is senior advisor on children and impact mitigation at the
International HIV/AIDS Alliance, www.aidsalliance.org
The International HIV/AIDS Alliance is supporting the Support. Don’t
Punish campaign (supportdontpunish.org) which calls on governments to
bring an end to the criminalisation and punishment of people who use drugs.
www.drinkanddrugsnews.com
September 2013 |
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