Youth R.I.S.E is a youth-led international network established to reduce the risks and harms associated with substance use and drug policy amongst young people and provide a platform for young people to be engaged in the policies that affect their lives.

Youth R.I.S.E es una red internacional dirigida por jóvenes que fue establecida para reducir los riesgos y los daños asociados al consumo de drogas y a las políticas de drogas entre los jóvenes. Youth R.I.S.E proporciona una plataforma de dialogo para que personas jóvenes puedan participar a las políticas que afectan a su vida.

Youth R.I.S.E. est un réseau international dirigé par des jeunes désirant réduire les risques et dommages subis par la jeunesse à cause de l’usage de drogues et de politiques de drogues inefficaces. Le réseau offre un espace permettant aux jeunes de s’impliquer dans les politiques qui touchent leur vie de tous les jours.

Youth RISE

Youth RISE will host an educational workshop on decriminalisation and the rights of young people who use drugs (YPWUD). To accommodate different time zones, there will be scheduled two identical sessions:

🕘 9:00 AM PT | 12:00 PM Colombia | 12:00 PM ET | 5:00 PM GMT

https://us02web.zoom.us/meeting/register/uoWoa9zrSXyF6QJuNVg29Q

🕚 11:00 AM GMT | 1:00 PM CAT | 5:00 PM Kyrgyzstan

🌍 Swahili and Russian interpretation available

https://us02web.zoom.us/meeting/register/9TBaDo4GT7-iKAQmW05IrA

•⁠ ⁠Youth-centric decriminalization

•⁠ ⁠Legal frameworks and advocacy skills

•⁠ ⁠YPWUD rights and harm reduction

•⁠ ⁠Practical applications and case studies

•⁠ ⁠Youth empowerment and representation

We hope to see you there and look forward to your participation and feedback!

Decriminalisation and the rights of young people who use drugs

This submission, made on behalf of IDPC, HRI and Youth RISE, summarises information collected from within IDPC’s network of Members and allies on the human rights implications monitoring and control that people in poverty are subjected to in the context of drug policy.

The report covers matters related to: child protection services and conditionalities associated with welfare and service provision (cash transfers,  housing, shelters, social security, drug treatment, education, and employment), concluding with recommendations on decriminalisation, harm reduction, and equitable access to social protections.

‘Welfare and control: The paternalism of support’ - Contribution to the upcoming report of the UN SR on extreme poverty

 is an international network of diverse young people who use drugs (YPWUD) and/or young people directly impacted by punitive drug policies. The organization advocates for the human rights, health, and well-being of this key population by promoting meaningful youth engagement in decision-making bodies, as well as local, national, regional, and international advocacy. Through capacity building aims to enable its membership to become experts in drug policy reform and Full Spectrum Harm Reduction (FSHR) advocacy and implementation. Youth RISE also supports youth-led initiatives and strengthening inclusive YPWUD community collaboration and develops tools and resources to support structural transformations in drug policy and harm reduction practices.

The organization’s advocacy strategy, developed in 2023, serves as the organizational compass, providing a comprehensive framework that aligns its projects and activities with its overall goals and mission to create impactful change while optimizing the use of valuable resources.

The strategy is founded on four key advocacy goals:

Representation and Elevation of YPWUD in Decision-Making Bodies Worldwide

Knowledge Management: Education, Research, and Data Collection

In this context, Youth RISE will focus on advocacy goal 3, which aims to develop and promote FSHR. This concept captures an inclusive, intersectional, and human rights-based approach that seeks to address and integrate the structural, social, legal, and political determinants that impact the lives and well-being of people who use drugs (PWUD), contributing to the perpetuation of inequalities in all aspects. It emphasizes that harm reduction should be for everyone, encompassing all drugs, all routes of use, and all people, no matter what their circumstances are. At the same time, it highlights how harm reduction efforts entail not only health services, but also mental health, housing, and social support systems as part of a holistic approach. By prioritizing intersectionality, Youth RISE emphasizes that diverse experiences—rooted in factors such as gender, socioeconomic status, and structural inequities—are central to its advocacy.

Following this advocacy goal, Youth RISE is developing the FSHR project, designed to contribute to a comprehensive understanding of its definition and principles, among young people, drug policy reform and harm reduction advocates, peers, policymakers, health and social care providers, educators, community leaders, researchers, and other stakeholders. This project is divided into a set of activities that include the publication of an FSHR statement by YPWUD and the production of a digital toolkit, which will include this report.

One of the main objectives of the present report, 

Connecting Theory, and Practice: Report on the Best Full Spectrum Harm Reduction Practices Survey

, is to gather insights and experiences from PWUD including young people, harm reduction practitioners, peers, policy advocates, social workers, and researchers worldwide, with a particular focus on the Global South perspectives, while still ensuring the inclusion of the Global North, capturing challenges, innovative strategies, and best practices that address the wide-ranging needs of YPWUD.

This specific focus on the Global South is due to the greater challenges faced by the countries within this region concerning social, economic, and political aspects, such as limited resources and deeper structural barriers (Duggan et al., 2021). By capturing the experiences of those involved in harm reduction efforts through a global survey, this report aims to get a better understanding of the particular gaps that still exist in these regions and explore potential practical examples of interventions that might be possible to adapt to other contexts.

The current report is committed to presenting key insights derived from the experiences and perspectives of the survey respondents across different contexts, namely Latin America, North and East Africa, Southeast Asia, Europe, and North America. The data collected shed light on innovative and contextualized interventions while identifying actionable strategies to advance harm reduction practices. It is important to note that this report emphasizes the work, experience, and efforts of those who are directly or have engaged in harm reduction initiatives, providing a qualitative understanding of harm reduction practices while serving as a complement to academic research on this matter (Boucher, et al., 2017; Rigoni, et al., 2021). Furthermore, the report seeks to also contribute to the ongoing discussions about harm reduction, placing inclusivity at its center.

A brief description of Youth RISE’s FSHR statement

An overview of the survey’s Best Full Spectrum Harm Reduction Practices framework

A characterization of the participants’ demographics

Quantitative and qualitative insights of FSHR

A summary of main findings, practical implementation examples, and its adaptation to different contexts

A final section providing recommendations and overall conclusions

Connecting theory and practice: Best practices of the full spectrum harm reduction – Survey report

Thursday, 27 February 2025 / 14:00 - 15:00 (London) - 

The tenth edition of the IDPC webinar on the regular session of the UN Commission on Narcotic Drugs (CND) focuses on its 

, which will take place in Vienna from 10-14 March 2025.

The webinar will shed light the key issues that are likely to structure the debates, discuss tabled resolutions and opportunities for engagement, and showcase the experience of IDPC network members in navigating and leveraging this forum for political advocacy.

This event will be available in English, Spanish and French.

 (International Drug Policy Consortium - IDPC).

CND 68: Key issues and opportunities

Full Spectrum Harm Reduction (FSHR) Statement

In past years, a growing body of evidence has demonstrated the effectiveness of harm reduction strategies in mitigating the negative consequences associated with drug use (Ritter and Cameron, 2006). In general terms, classic harm reduction programs aim to reduce the potential harms associated with drug use without putting abstinence as the main goal, emphasizing instead empathy, a human rights approach, and respecting people where they are at (Pauly et al., 2019; Nyx and Kalicum, et al., 2024). Harm reduction strategies and interventions include a range of actions such as needle and syringe exchange programs (Smith et al., 2021), naloxone distribution (Davis et al., 2023), safe consumption rooms (Thompson et al., 2022), opioid agonist treatment (Johnson & Lee, 2022), overdose prevention programs, drug checking programs (Garcia & Patel, 2023), peer-led interventions (Martinez et al., 2022) and drug education in recreational and educational settings. These programs have successfully engaged key populations as peer educators and mentors, highlighting the effectiveness of community engagement in harm reduction efforts (Marshall et al., 2016). However, it is important to note that not all harm reduction programs have successfully engaged key populations, particularly youth. Evidence shows that adequate and meaningful engagement of key populations, including youth, is essential for the effectiveness of these programs. Yet, most harm reduction services significantly lack this engagement, which must be addressed to ensure that harm reduction efforts are truly inclusive and impactful (Stowe et al., 2022; Ashford, Curtis, & Brown, 2018).

The UN officially recognizes a limited set of harm reduction interventions endorsed by WHO, UNODC, and UNAIDS, focusing primarily on HIV prevention among people who inject drugs through measures like needle and syringe programs, opioid substitution therapy, HIV testing, antiretroviral therapy, STI prevention and treatment, condom distribution, and hepatitis and tuberculosis care (WHO, UNODC, & UNAIDS, 2012). In 2022, the WHO released new 

Consolidated Guidelines on HIV, Viral Hepatitis and STI Prevention, Diagnosis, Treatment and Care for Key Populations

, which cover a wider range of interventions, including naloxone distribution, and enabling interventions such as community empowerment and removing punitive laws, policies and practices to enhance the effectiveness of these services (WHO, 2022, p. 51). This update reflects progress in the range of harm reduction interventions, but significant gaps remain. Notably, the prioritization of these guidelines is often absent in UNODC-led drug policy discussions, such as at the Commission on Narcotic Drugs. Moreover, emphasis on meaningful community engagement (particularly youth involvement) in all aspects of harm reduction service design, development, implementation, monitoring, and evaluation is missing as well as on the need for tailored services for young people who use drugs. This narrow approach, perpetuated by those in power, continues to limit harm reduction services and reflects the broader struggle faced by harm reduction practitioners, who encounter significant adversity when advocating for a comprehensive approach aimed at adequately supporting the diverse and evolving needs of people who use drugs.

It is undeniable that harm reduction saves lives, reduces health impacts associated with drug use, and promotes the empowerment of communities historically marginalized by prohibitionist and punitive drug policies. These interventions have effectively challenged the dominance of abstinence-based approaches and have contributed to a paradigm shift in drug policy discourse. However, it is crucial to acknowledge and improve our understanding of how to address the complex interplay of broader sociopolitical structures that influence health disparities within this population (Smith et al., 2021; Johnson & Lee, 2022). These structural determinants intersect with diverse identities and experiences, including but not limited to young people, people experiencing homelessness or poverty, sex workers, women, LGBTIQA+ people, racialized communities, indigenous peoples, migrants, displaced people, incarcerated or detained persons, those with disabilities, people living with HIV, tuberculosis, or hepatitis, and rural populations. The intersection of these vulnerabilities, without adequate policies and services to support them, creates a cycle of social and systemic exclusion, making it harder for people who use drugs to access appropriate care and support (Collins, et al., 2019; United Nations Human Rights Council, 2024)

Therefore, Full Spectrum Harm Reduction aims to expand the classical scope of harm reduction to encompass a more comprehensive, context and intersectionality-aware approach that addresses both the immediate and underlying factors contributing to harm. This approach not only includes traditional harm reduction strategies but also looks to broader interventions that target other social determinants of health, legal protections, community empowerment, and meaningful engagement in all aspects that affect them. This includes ensuring access to housing, food, education, and employment, as well as legal assistance and protection from discrimination and violence.

Why the context matters in reducing the harm

The context in which drug-related harm occurs is relevant to better understanding and mitigating it. The individual choices that might lead to negative impacts of drug use cannot be isolated from the external factors that profoundly shape people’s lives and their available scope of options, such as social inequalities, legal frameworks, political policies, and economic landscape, among others. Consequently, the effectiveness of harm reduction strategies is highly influenced by the context in which these are implemented (Collins, et al., 2019) which highlights the importance of considering other root causes of harm that perpetuate cycles of disadvantage and marginalization among people who use drugs, such as criminalization, social stigma, poverty, and lack of access to essential services, including justice services (i.e., legal support, health care services, access to education, housing, etc.). The oppression and marginalisation faced by people who use drugs are some of the main causes of the harms experienced by this community (Hassan, 2022). Therefore, harm reduction must engage with these broader determinants, recognizing that the harms people face are often the result of complex interactions between individual behavior, social positioning, and structural forces (Collins et al., 2019).

Drug control policies often intersect with and exacerbate other forms of discrimination, disproportionately affecting marginalized populations. The criminalization of drug use exemplifies how legal contexts can exacerbate harm. By pushing people underground, punitive approaches to drugs raise barriers to access to healthcare services, driving people who use drugs into environments where certain risks, such as overdose, disease transmission, and violence exposure are greater. Moreover, the success of evidence-based harm reduction programs, such as safe consumption rooms, can be significantly reduced in areas where drug use is heavily criminalized, as fear of arrest or police abuse is likely to deter people from accessing these services (United Nations Human Rights Council, 2024).

Criminalization is a key driver of stigma towards people who use drugs and negatively influences the way this population is treated by health care services and staff. Stigmatizing attitudes in health care providers can lead to reluctance in this key population to seek healthcare services, increasing their vulnerability to communicable diseases such as HIV, tuberculosis, and hepatitis. This stigma affects not only their access to essential non-drug-related medical care, such as treatment for injuries or emergencies but also limits the delivery of effective drug-treatment programmes (United Nations Human Rights Council, 2024). If healthcare programs are based on stigmatizing values, such as prioritising drug abstinence or requiring people who use drugs to be "clean from drugs" in order to receive support, people who do not fit in these categories will not reach these services, reinforcing barriers to care.

Harm reduction must continue to provide the right tools and create adequate conditions for the promotion of people’s safety and well-being, therefore maintaining its potential of being a pathway for liberation.

Full Spectrum Harm Reduction aligns with the vision of harm reduction as a liberatory practice that empowers marginalised communities to create systems of change and mutual support outside traditional structures. By adopting Full Spectrum Harm Reduction, we aim to unify liberation struggles, recognizing that the harm reduction movement can serve as a platform for broader societal transformation (Hassan, 2022).

In this matter, Full Spectrum Harm Reduction must also be intersectional, recognizing that people who use drugs are not a homogenous group. It must be tailored to meet the diverse needs of people based on their social location, such as age, gender, race, sexual orientation, socioeconomic status, and legal status, otherwise, it may fail to address their unique risks. For example, young women who use drugs often face heightened risks of violence and stigma, needing harm reduction services that are integrated with gender-based violence prevention and reproductive health services (United Nations Human Rights Council, 2024). Full Spectrum Harm Reduction must also engage with and be led by the communities it serves, recognizing that those most affected by harm are the ones best positioned to identify and implement solutions (Hassan, 2022).

Full Spectrum Harm Reduction must cover all populations that are at risk of harm due to drug use, as well as those affected by intersecting forms of oppression and marginalization. This includes, but is not limited to:

Youth: young people who use drugs may face particular challenges related to age-specific stigma and criteria for services, lack of access to youth-tailored services, lack of financial resources, and legal vulnerabilities and obstacles.

Women: especially those who face gender-based violence and discrimination, requiring integrated harm reduction services that address their specific health and safety needs.

LGBTQI+ people: who may face unique risks related to discrimination, stigma, and legal persecution, necessitating harm reduction services that are culturally competent and inclusive.

Sex workers: who are often at the intersection of multiple forms of stigma and violence, and who require harm reduction services that address their specific vulnerabilities.

Migrants and non-recognized citizens: who are often subject to heightened legal risks, discrimination, violence, and barriers to accessing basic services, and who require approaches that address these specific challenges.

People experiencing homelessness or poverty: who are disproportionately affected by the social determinants of health that exacerbate the harms of drug use, and who require harm reduction services that include access to housing, food, and social services.

Neurodivergent people and people facing mental health issues: who may use drugs as a form of self-medication and who require services that are integrated with mental health support.

Incarcerated or formerly incarcerated people: who face specific risks related to drug use, including lack of access to harm reduction services in prison and barriers to reintegration upon release.

People with disabilities: those whose disability-related needs require acknowledgment, including accommodations for physical and communication needs.

A more holistic harm reduction framework must incorporate strategies that target the underlying structural inequities perpetuating health disparities. This may include advocating for policy reforms, addressing socioeconomic determinants of health, combating stigma and discrimination, and promoting social justice initiatives. By expanding the scope of harm reduction to encompass these broader systemic factors, interventions can more effectively mitigate the multifaceted harms experienced by people who use drugs and promote sustainable, equitable health outcomes.

Full Spectrum Harm Reduction is not a static concept; it is an ongoing process that evolves in response to changing social dynamics, scientific evidence, and more importantly, the needs of the community. It must be flexible, inclusive, and responsive to the realities of people who use drugs, adapting to the specific circumstances and challenges faced by different populations, and it must be grounded in a commitment to social justice, gender equality, human rights, and community empowerment.

Ashford, R. D., Curtis, B., & Brown, A. M. (2018). Peer-delivered harm reduction and recovery support services: Initial evaluation from a hybrid recovery community drop-in center and syringe exchange program. Harm Reduction Journal, 15(52). https://doi.org/10.1186/s12954-018-0258-2

Collins, A. B., Boyd, J., Cooper, H. L. F., & McNeil, R. (2019). The intersectional risk environment of people who use drugs. Social science & medicine (1982), 234, 112384. https://doi.org/10.1016/j.socscimed.2019.112384

Davis, K., Smith, J., & Thompson, R. (2023). Community-based naloxone distribution and its impact on opioid overdose deaths: A systematic review. Journal of Substance Abuse Treatment, 145, 108-115. https://doi.org/10.1016/j.jsat.2023.108115

Garcia, L., & Patel, M. (2023). Evaluating the effectiveness of drug checking services at music festivals: A cohort study. International Journal of Drug Policy, 109, 103-110. https://doi.org/10.1016/j.drugpo.2023.103110

Hassan, S., & Lewis, D. G. (2022). Saving our own lives: A liberatory practice of harm reduction. Chicago, IL: Haymarket Books.

Johnson, A., & Lee, C. (2022). The impact of opioid agonist treatment on overdose mortality: A cohort study. Addiction Science & Clinical Practice, 17(1), 45-52. https://doi.org/10.1186/s13722-022-00273-5

Martinez, S., Brown, T., & White, E. (2022). Peer-led harm reduction interventions: A randomized controlled trial on engagement with addiction treatment services. Harm Reduction Journal, 19(1), 22-30. https://doi.org/10.1186/s12954-022-00567-y

Ritter, A. and Cameron, J. (2006). A review of the efficacy and effectiveness of harm reduction strategies for alcohol, tobacco and illicit drugs. Drug and Alcohol Review, 25(6), 611-624. https://doi.org/10.1080/09595230600944529

Pauly, B., Brown, M., Evans, J., Gray, E., Schiff, R., Ivsins, A., … & Stockwell, T. (2019). “there is a place”: impacts of managed alcohol programs for people experiencing severe alcohol dependence and homelessness. Harm Reduction Journal, 16(1). https://doi.org/10.1186/s12954-019-0332-4

Nyx, E., & Kalicum, J. (2024). A case study of the DULF compassion club and fulfillment centre-A logical step forward in harm reduction. The International journal on drug policy, 131, 104537. Advance online publication. https://doi.org/10.1016/j.drugpo.2024.104537

Marshall, B. D., Green, T. C., Yedinak, J. L., & Hadland, S. E. (2016). Harm reduction for young people who use prescription opioids extra-medically: obstacles and opportunities. International Journal of Drug Policy, 31, 25-31. https://doi.org/10.1016/j.drugpo.2016.01.022

Smith, R., Chen, Y., & Garcia, P. (2021). High coverage of needle and syringe programs and its association with HIV incidence: A meta-analysis. BMC Public Health, 21(1), 1234-1242. https://doi.org/10.1186/s12889-021-11345-x

Stowe, M. J., Feher, O., Vas, B., et al. (2022). The challenges, opportunities, and strategies of engaging young people who use drugs in harm reduction: Insights from young people with lived and living experience. 

(83). https://doi.org/10.1186/s12954-022-00663-z

Thompson, H., Williams, J., & Carter, A. (2022). The impact of drug consumption rooms on overdose-related emergency medical service calls: Evidence from Canada. Substance Use & Misuse, 57(4), 517-525. https://doi.org/10.1080/10826084.2022.2034567

United Nations Human Rights Council. (2024). Drug use, harm reduction and the right to health: Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, Tlaleng Mofokeng (A/HRC/56/52). https://undocs.org/A/HRC/56/52

World Health Organization, United Nations Office on Drugs and Crime, & Joint United Nations Programme on HIV/AIDS. (2012). 

Technical guide for countries to set targets for universal access to HIV prevention, treatment and care for injecting drug users: 2012 revision

. Geneva, Switzerland: World Health Organization https://www.who.int/publications/i/item/978924150437

Consolidated guidelines on HIV, viral hepatitis and STI prevention, diagnosis, treatment and care for key populations

. Geneva: World Health Organization https://www.who.int/publications/i/item/9789240052390

Youth RISE statement on Full Spectrum Harm Reduction

Youth RISE conducted a research working group on Young People Who Use Opioids (YPWUO) during November and December 2023. In March 2024, the report was released on Youth RISE’s website. Key findings from this report were also presented during a side event at the 67th session of the Commission on Narcotic Drugs in Vienna. Youth RISE now seeks to share the findings with the public at large.

 involved eight representatives from Canada, Indonesia, Kenya, Mexico, Portugal, Uganda, the United States, and Zimbabwe. These representatives collected data from their respective countries using a qualitative approach, focusing on the needs and challenges of YPWUO and harm reduction practitioners. Key themes were identified, including stigma, discrimination, lack of healthcare, policy issues, and political inaction to address these main issues. The findings highlight the urgent need for policymakers, state representatives, and other stakeholders to act in order to protect the rights and lives of young people who use opioids, including supporting harm reduction strategies.

The report presents results and recommendations from a discussion held by a cohort of young people who are using opioids and harm reduction practitioners based in various regions worldwide.

For more information on the event and the full programme of guest speakers, go to 

https://youthrise.org/youth-rise-presents-the-report-catalysts-for-change-youth-driven-insights-in-opioid-harm-reduction/

Entre noviembre y diciembre de 2023 Youth RISE llevó a cabo un grupo de trabajo de investigación sobre personas jóvenes que usan opioides. En marzo de 2024, se publicó el 

 en el sitio web de Youth RISE. Los hallazgos clave de este informe también se presentaron durante un evento paralelo en la 67º sesión de la Comisión de Estupefacientes (CND) de las Naciones Unidas, en Viena. Este webinar, buscamos compartir los resultados de este informe.

El informe “Catalysts for Change” presenta la información cualitativa recopilada de ocho representantes de Canadá, Indonesia, Kenia, México, Portugal, Uganda, Estados Unidos y Zimbabue que se autoidentifican como personas jóvenes que usan opioides, reductores de daño, o bien, como ambas. Los temas centrales se centran en sus necesidades y los desafíos que tienen que afrontar. Entre los temas clave se identificaron el estigma, la discriminación, la falta de acceso a servicios de salud, y la inacción política frente a soluciones que aporten a estas comunidades. Además, los hallazgos puntualizan la necesidad de una acción inmediata por parte de politico, tomadores de decisiones y otros actores relevantes para proteger los derechos y vidas de estos jóvenes, incluyendo el apoyo a programas de reducción de daños.

Youth Rise presents the report “Catalysts for change: youth-driven insights in opioid harm reduction”

This project aimed to improve leadership transitions, institutional memory, and long-term strategy in the participating organisations through the development and implementation of a youth-work Sustainability Framework designed with best practices from both the youth-work sector and the drug policy/harm reduction sector. The key results include The Development of the Framework, The Implementation of the Framework, and the increased stability of the participating organisations in the European Union (EU).

“Youth In Power” (YIP) was and is intended to continually improve the overall sustainability stability of three participating youth-led organisations, SSDP International, Young Wave, RISE, by addressing key areas: 1. Leadership transitions, 2. Institutional knowledge/memory, 3. Long-term strategy. The goal incorporate tools best practices from both youth work sector drug policy/harm reduction develop implement a Sustainability Framework that addresses these issues. To achieve our improving organisational through its implementation, we organised 3-day strategy meeting. This will also be shared utilised across allow for benefits this applied on wider scale ensure sustained robust policy sector.

'Youth in power': Addressing sustainability of youth-led drug related organisations

The UNDOC 2023 World Drug Report provides insights into the prevalence of opioid use among individuals aged 15-65 in different regions. In Africa, the prevalence stands at 1.24%, which represents 9,670,000 people. Europe has 3,790,000 users, revealing a prevalence of 0.78%. The Americas reports 11,940,000 people who use opioids and a prevalence rate of 1.74%. Meanwhile, in East and Southeast Asia, 2,780,000 people experience opioid use, representing a prevalence of 0.17% (UNDOC, 2023).

The response to opioid use among young people remains a public health concern in every region of the cohort. Addressing the specific needs of young people who use opioids (YPWUO) demands a profound commitment to elevate their voices and support them to lead this urgent discussion. Furthermore, it is essential to acknowledge the role of harm reduction in responding to their needs and challenges.

The objective of this article is to present the results and recommendations from a discussion held by a cohort consisting of young people who are using opioids, harm reduction practitioners, or, in some cases, both, based in various regions worldwide. The discussion was divided into a series of conversations centered on understanding the needs and challenges faced by young people who use opioids (YPWUO) and harm reduction practitioners.

The article is organized into a total of five divisions. The initial division offers a concise elucidation of the employed methodology.Subsequently, the second division encompasses the political backdrop surrounding drug use and the availability of harm reduction services (HRS) in each respective setting where the collaborators are situated. The third division presents the prominent themes that emerged from online discussions regarding the barriers to access to harm reduction and health services and the needs of young individuals who consume opioids and harm reduction professionals. The fourth division expounds upon recommendations that aim to effectively address the necessities and challenges encountered by this particular group of young people who use opioids and harm reduction professionals. The fifth division concludes the article by providing some final remarks.

Catalysts for change: Youth-driven insights in opioid harm reduction

We, the undersigned organisations, are deeply concerned about the drastic intensification of anti- drug operations in Sri Lanka leading to significant human rights violations.

On 17 December 2023 the Acting Inspector General of Police Deshabandu Tennekoon, with the endorsement of Minister of Public Security Tiran Alles, spearheaded an operation titled “Yukthiya”, with the stated aim of controlling “the drug menace”. The operation is ongoing as of 10 January 2024, with at least one thousand persons arrested daily.

This operation is unfolding in a context of already severe repression against persons who use or are suspected of using drugs, who suffer discrimination and stigma within the Sri Lankan criminal justice system and society.

Alongside the Sri Lankan police, members of the armed forces have been supporting this operation, during which several human rights violations have been reported. These violations include alleged arbitrary arrests, primarily against individuals from marginalised socio-economic communities; searches conducted without warrants or reasonable suspicion; and degrading treatment including strip searches in public as well as cavity searches. The searches and arrests have been televised, in violation not only of the right to privacy (and of basic human dignity) but also of a person’s right to be presumed innocent. According to lawyers, persons are being arrested even when no drugs are found in their possession, simply for having been arrested for drug offences or having been sent to compulsory rehabilitation in the past. The arrests of main livelihood earners and mothers have adversely impacted the ability of families to meet their basic needs during a time of economic crisis in Sri Lanka, and the wellbeing of children.

Persons are being arrested primarily under Section 54A of the Poisons, Opium and Dangerous Drugs Ordinance, an offence which is non-bailable. As a result, those arrested are bound to spend time (sometimes months) in pretrial detention, thereby exacerbating already poor conditions of imprisonment in an overburdened prison system. The Human Rights Commission of Sri Lanka has previously stated that the existing prison conditions and treatment of incarcerated persons are “inhumane and degrading.”At present, as per statistics issued by the Department of Prisons, the level of overcrowding of the prison system is at nearly 200% - with punitive drug policies playing a significant role: as of 2022, 63% of convicted persons were sentenced for drug-related offences.

The total reported number of arrests pursuant to operation Yukthiya has exceeded 29,000 as of 9 January 2024, while nearly 1,500 people are in administrative detention in police custody for further investigation.  At least 1,600 more persons have been sent for compulsory drug rehabilitation, in violation of several fundamental rights; including the right to the highest attainable standard of health, which includes the right to consent to and withdraw from medical treatment. “Drug treatment” in these centres is abstinence-based, essential harm reduction services are not available, and persons undergo severe withdrawal symptoms without any medical assistance while in detention. The use of violence to discipline and punish has been reported in at least two compulsory drug rehabilitation centres which are within the purview of the Bureau of the Commissioner General for Rehabilitation and are operated by the military, which is in itself a violation of international standards.

The UN Working Group on Arbitrary Detention in its statement at the conclusion of its visit to Sri Lanka in 2017 expressed concern regarding the involvement of military personnel in drug treatment and rehabilitation, the fact that strenuous physical exercise was the core component of compulsory drug treatment, and at the lack of trained professionals to monitor the health of people in detention. Furthermore, the statement highlighted the irregularities in the judicial process by which persons were sent to drug rehabilitation centres without a medical assessment.

More broadly, the UN Special Rapporteur on Torture has highlighted that by denying persons access to substitution therapies, states are subjecting “a large group of people to severe physical pain, suffering and humiliation, effectively punishing them for using drugs and trying to coerce them into abstinence.” The Special Rapporteur has further stated “forcible testing of people who use drugs without respecting their autonomy and their right to informed consent may constitute degrading treatment, especially in detention settings. States are obliged to respect the enjoyment of the right to health, including by refraining from using coercive medical treatment. The requirement of informed consent, including the right to refuse treatment, should be observed in administering any treatment for drug dependence.”

Since the 2016 UN General Assembly Special Session on drugs, there is international consensus on pursuing a holistic and health and human rights-based approach to drugs, which encompasses supply and demand reduction as well as harm reduction. The 2019 Ministerial Declaration on drugs – the current global drug policy document - as well as multiple resolutions of the UN General Assembly, the UN Commission on Narcotic Drugs, and the UN Human Rights Council reiterate and recommend a similar approach.

A punitive and militarised approach to drug control contravenes recognised international human rights standards and guidelines, is ineffective to protect individual and public health, and ultimately fails to make communities safer.

Africa Network of People Who Use Drugs (AfricaNPUD) (Africa)

Anti-Death Penalty Asia Network (ADPAN) (Asia)

Association for Humane Drug Policy (Norway)

Centre on Drug Policy Evaluation (CDPE) (Canada)

Centro de Estudios Legales y Sociales (CELS) (Argentina)

Corporación Acción Técnica Social (Colombia)

Correlation - European Harm Reduction Network (Europe)

Drug Harm Reduction Advocacy Network Nigeria (Nigeria)

Foreningen Tryggere Ruspolitikk /Safer Drug Policies (Norway)

GREA - Groupement Romand d'Etudes des Addictions (Switzerland)

Helsinki Foundation for Human Rights (Poland)

International Commission of Jurists (ICJ)

International Drug Policy Consortium (IDPC) (Global)

International Network of People who Use Drugs (INPUD) (Global)

Skoun, Lebanese Addictions Centre (Lebanon)

Zimbabwe Civil Liberties and Drug Network (Zimbabwe)

Youth RISE

Region

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