Adolescent Substance Use: Risk and Protection

Adolescent Substance Use: Risk and Protection

Adolescent Substance Use: Risk and Protection

Adolescent Substance Use: Risk and Protection


The Asian and Pacific region has some of the world's toughest laws against drug abuse and drug trafficking, yet drug use amongst young people is increasing, with the starting age as low as 12 years old in some countries. Issued jointly by UN Economic and Social Commission for Asia and the Pacific (ESCAP) and UN Office on Drugs and Crime, this publication examines how to plan and deliver effective treatment and rehabilitation programmes for adolescent substance users. Sections consider: treatment approaches to youth drug use, analysis of risk and protective factors, examples of successful intervention, treatment and aftercare programmes, and implications for programme development.


Substance abuse has been identified by the World Health Organization (WHO) as one of three major health risks that can lead to devastating health consequences for adolescents. Substance abuse can lead to illness and even death, and it is also related to unsafe sex, accidents, violence and loss of productivity (WHO 2001).

Drug use among youth has increased exponentially in South-East Asia, affecting younger and wider segments of society. Amphetamine-type stimulants (ATS), mainly amphetamines, methamphetamines and ecstasy, are the main problem drugs in the subregion and their use has increased dramatically in recent years. There has been a notable trend of increased ATS use among young people. Overall substance abuse among high school and college students in this region doubled between 1994 and 1998, and it appears to have doubled again in 1999 with ATS being the main substances responsible for the rise (UN ODCCP 2002).

At the same time, medical and psychiatric facilities in the region are inadequate for coping with the increasing number of drug users. Counselling facilities and rehabilitation centres are scarce. The high relapse rate of current drug treatment programmes, most of which are concentrated in urban areas, indicates a need for new approaches to deal with demand and treatment.

Only a few institutions and organizations in Asia have been successful in providing alternative approaches to prevention, treatment and rehabilitation. Furthermore, much of their work has been undertaken at the pilot level. There is potential to scale up these interventions and at the same time to incorporate new approaches, such as the integration of “protective factors”, to reverse or reduce known risk factors that predispose young people to drug use.

Adolescent Substance Use: Risk and Protection focuses on the treatment of illicit substance use among young people, including abuse of amphetamines, opiates, depressants, hallucinogens, cocaine and cannabis.

It presents an analysis of research on the application of risk and protective factors that addresses substance abuse among adolescents aged 12 to 24 years. On the continuum of care from primary prevention, secondary prevention, assessment, intervention, treatment and aftercare, it focuses on the latter three.

Section 1 examines the reasons for drug use among adolescents and illustrates the sequential stages of substance use. This Section also provides an overview of traditional approaches to intervention and treatment and the extent to which each has been proved successful.

Section 2 analyses the risk and protective factors that influence young people's attitudes and behaviours towards substance abuse. Section 2 also examines the framework for risk and protective factors and how these factors have been applied to the development of intervention, treatment and aftercare.

Examples of specific programmes that have applied these factors in developing successful therapeutic responses to adolescent substance abuse are presented in Section 3.

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