Children and Young People in Global Drug Policy: From “Protection” Rhetoric to Rights-Based Reform
Special Section: Health, Rights, and the Future of Global Drug Control
Anna Tomasi and Ruby Rose Lawlor
The idea of protection, and its consequences
Protecting children has long been one of the most powerful justifications for international drug control. Many harms to children and young people arise from drug use and illicit markets, but others stem from the measures used to control them. Drug policy reaches children through development programs, police stations and courts, clinics, schools, and social services. Yet the effects of drug control on children themselves have received comparatively little attention.
This gap is visible across major international drug policy processes and institutions. Between 2000 and 2026, the United Nations Commission on Narcotic Drugs (CND) adopted approximately 300 resolutions, but only 19 focused specifically on children and young people. Of these, only six addressed issues other than drug use prevention, including just one resolution each on children’s involvement and exploitation in illicit drug economies, pediatric access to essential controlled medicines, and specialized treatment for children and young people with drug use disorders. Harm reduction for young people who use drugs has never been addressed in a CND resolution, and no resolution explicitly recognizes harms generated by drug policy itself.[1] Moreover, although the 2016 United Nations General Assembly Special Session (UNGASS) on the world drug problem was convened under the banner of securing “a better tomorrow for today’s youth”—and made some important commitments around prevention, specialized treatment, and juvenile justice—neither the process nor the outcome document scrutinized how drug policies themselves affect the lives of children.[2]
Resolution 68/6 broke new ground at the CND by mandating an independent review of the operation of the global drug control system.[3] The independent review offers a rare opportunity to examine how this system affects children and young people, and why their rights and experiences have remained peripheral to its work. A limited conception of “protection” has long prevailed in global drug policy, with the emphasis placed on preventing or delaying drug use and suppressing illicit markets.
Prevention remains an essential component of protecting children and young people, but it must be evidence based, age-appropriate, and consistent with their rights to health, education, and access to information. Approaches centered primarily on abstinence or deterrence risk overlooking the diverse circumstances of young people, including those who already use drugs and require accurate information and accessible support. A human rights-based approach must therefore consider not only whether prevention programs seek to reduce drug use but also whether they respond effectively to children’s needs and respect their rights.[4]As outlined in the International Guidelines on Human Rights and Drug Policy, schools should avoid excluding children due to risk-taking behaviors and avoid using ineffective and violating practices such as random drug testing, sniffer dogs, and strip searches.[5]
Preventing drug use and protecting children from exploitation in illicit drug markets are legitimate and important objectives, reflected in article 33 of the Convention on the Rights of the Child (CRC), which also explicitly refers to the international drug control conventions.[6] But drug policies adopted to protect children from drugs and to control the illicit market must also be considered against the CRC as a whole. Set against this full framework, some measures adopted in the name of protection from drugs become difficult to justify and defend. Arrest and detention, for example, can interrupt education and family life. Restrictions on controlled medicines can leave children in unnecessary pain. Age and consent rules can keep young people away from health services. And children recruited into illicit drug markets can be prosecuted for conduct associated with their exploitation. These issues, and related rights, belong within any serious assessment of whether drug policy actually protects children.
The Committee on the Rights of the Child has emphasized that measures to protect children from drugs must be consistent with their rights under the CRC as a whole, including their best interests, health, participation, and protection from arbitrary detention. This broader interpretation of article 33 provides an important basis for assessing the consequences of drug control measures for children.[7]
When policies intended to protect cause harm, or neglect key issues
Health
The drug control system is meant to prevent diversion while ensuring that controlled substances are available for medical and scientific purposes.[8] More than 80% of people who need essential opioid medicines lack adequate access.[9] Among them, as many as 21 million children need palliative care each year.[10] Over 10 million children and adolescents aged 0–19 experience serious health-related suffering annually, almost all of them in low- and middle-income countries.[11] Many die in unnecessary pain. For children with cancer and other life-limiting conditions, shortages can mean severe pain at the end of life even when effective medicines exist. Liquid oral morphine, which allows accurate dosing and easier administration, remains unavailable in many low- and middle-income countries because of restrictive regulation, supply problems, and limited clinical training.[12] Despite repeated CND attention to access to controlled medicines generally, only one resolution has explicitly focused on children’s needs.[13]These barriers also raise questions under the right to health, which requires states to ensure access to essential medicines without discrimination. The availability of controlled medicines for children should therefore be assessed not only against drug control obligations but also against states’ wider human rights commitments.[14]
Young people who use drugs can encounter the consequences of this approach from another direction, as punitive laws, stigma, age restrictions, and weak confidentiality protections deter them from seeking information, treatment, or support. In some settings, people under the age of 18 are formally excluded from harm reduction services that are available to adults.[15] Age thresholds do not prevent drug use, but they can prevent access to proven methods of reducing the risks of overdose, HIV, hepatitis, and other drug-related harms.
Age-based exclusions from harm reduction and other health services undermine children’s rights to health, life, and survival and development and should be justified by compelling evidence rather than assumptions about protection. The International Guidelines on Human Rights and Drug Policy recognize the importance of ensuring that children and young people have access to evidence-based, age-appropriate information and services, including harm reduction. This requires attention not only to formal age restrictions but also to confidentiality, informed consent, and the practical accessibility of services.[16]
Criminal justice
Approximately 410,000 children are detained annually in prisons and remand centers worldwide, excluding police custody. Around 259,000 are deprived of liberty on any given day, and an estimated one million children are held in police custody each year.[17] Reliable global figures for detention specifically for drug-related offenses do not exist. Most countries do not report child detention by offense type, and global drug-arrest data are rarely disaggregated by age.[18] The drug policy share of this detention at the global level therefore cannot be established. National figures nevertheless show substantial numbers of children entering criminal justice systems for drug-related offenses. In Brazil, for example, drug trafficking accounted for 27% of offenses among adolescents deprived of liberty in 2023.[19] Detention should be a measure of last resort, yet it is often the first option—and it can expose children to further human rights violations, including violence, while disrupting their education and family relationships and limiting their access to health and psychosocial support.
Criminal records, interrupted schooling, and reduced employment opportunities can extend the effects of detention well beyond the sentence. Perversely, the age thresholds governing punishment and health care can pull in opposite directions. Some jurisdictions allow children to be held criminally responsible at an age when harm reduction or confidential health services remain closed to them. In other words, a child can be old enough to be penalized for drug use or possession yet too young to use a service intended to reduce the risks of drug use. These concerns have been raised by the UN Working Group on Arbitrary Detention, which has examined the human rights implications of drug policies, including for children. The working group has emphasized the need to avoid criminalizing children for drug use or possession for personal use and to ensure that the best interests of the child and appropriate juvenile justice safeguards are respected.[20]
Families
Parental incarceration can lead to family separation, economic hardship, and disrupted caregiving, extending the effects of drug enforcement well beyond the person convicted. In Latin America and the Caribbean, for example, an estimated 1.7–2.3 million children have a parent in prison, including approximately 500,000 affected by incarceration for drug-related offenses. The consequences can persist throughout childhood through the loss of household income, changes in living arrangements, stigma, and emotional distress, disrupting education and placing additional caring responsibilities on children themselves. The imprisonment of mothers can be particularly disruptive where they are primary caregivers.[21] Child-welfare systems can compound these effects when parental drug use is treated as evidence of unfitness rather than one factor in an individual assessment of the child’s circumstances.[22] The CRC and the UN Guidelines for the Alternative Care of Children offer an alternative lens, emphasizing that unnecessary family separation should be prevented, that families should be supported in caring safely for their children, and that decisions to separate a child from their parents should be based on an individual assessment of the child’s best interests rather than parental drug use alone.[23] Drug dependence among parents should therefore be approached primarily as a public health and social welfare issue, with appropriate support for families rather than automatic recourse to separation.
Exploitation and violence
For children recruited into illicit drug economies, the distinction between victim and offender can become difficult to sustain. Children may be used as lookouts, couriers, or street-level sellers, with recruitment occurring in contexts marked by poverty, violence, and social exclusion.[24] Their recruitment can also serve the interests of criminal groups, since children are cheap to use and can be deployed in roles carrying a high risk of detection.[25] Yet when authorities encounter them, the very activities they have been exploited to carry out can become the basis for arrest, prosecution, and detention. These risks are particularly acute for children living in poverty and from marginalized communities, where exposure to illicit drug economies may intersect with discriminatory policing and limited access to education, social protection, and other services. Responses should recognize these intersecting vulnerabilities and prioritize protection, rehabilitation, and reintegration over punishment.[26]
UN Security Council Resolution 2427 emphasizes protection, rehabilitation, and reintegration for children associated with armed groups, and the Inter-American Commission on Human Rights has applied a similar child-protection approach to recruitment and exploitation by organized criminal groups.[27] The only CND resolution substantially addressing children’s involvement in drug-related activities recognizes their exploitation but does not establish that exploited children should be treated primarily as victims, nor does it provide for diversion or non-prosecution on the basis of that exploitation.[28] The 2016 UNGASS outcome document called for alternatives to conviction and punishment for children in appropriate cases but similarly did not sufficiently connect those protections specifically to children recruited or exploited in illicit drug economies.
The Convention on the Rights of the Child as a child-focused normative framework for the independent review
The UN drug control system has been weak at investigating specific harms to children and taking accountability for the ways in which drug policies can generate these harms or cause them to be less visible. The UN drug control conventions do not, on their own, provide an adequate framework for assessing such harms. Although the international drug control system is grounded in a stated concern for the “health and welfare of mankind,” its three conventions say remarkably little about children and young people. Only the 1988 Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances refers to them explicitly, principally in relation to exploitation in the illicit drug trade and increased penalties for offenses involving children.[29] Article 33 of the CRC is unusual in that it explicitly refers to the international drug control conventions. But it does not make protection from illicit drugs a self-contained obligation, nor does it reaffirm what the drug conventions say.
Article 33 sits within a convention that also requires the best interests of the child to be a primary consideration and that protects the rights to life, survival and development, health, education, family life, privacy, information, and participation. The CRC protects rights in relation to juvenile justice, and it requires that deprivation of liberty be a measure of last resort and for the shortest appropriate period.[30] These obligations raise questions that the drug conventions do not. Does the arrest of a parent for a nonviolent drug offense serve a child’s best interests? When can compulsory drug treatment be justified for a child? How should restrictions intended to control medicines be assessed when they leave children in avoidable pain? The CRC therefore offers the independent panel a near-universally accepted legal framework through which the effects of drug control on children can be assessed. The independent review should also build on the work of UN human rights mechanisms, including successive reports of the Office of the United Nations High Commissioner for Human Rights and findings of the Special Procedures, which have examined the human rights consequences of punitive drug policies and called for approaches grounded in health, human rights, and nondiscrimination.[31]The independent review should draw on this existing body of analysis rather than assess the drug control system in isolation. Resolution 68/6 explicitly includes “the obligations of other relevant international instruments” in the mandate of the independent review panel. The CRC must form a baseline for children and young people.
From rhetoric to rights-based reform
The review created by Resolution 68/6 gives the CND an opportunity to examine how the international drug control system affects children and young people, including through deprivation of liberty, criminal records, barriers to health services and controlled medicines, family separation, and exploitation in illicit drug economies. It also presents an opportunity to consider systems and tools for accountability for children and young people moving forward. The CRC provides the normative framework, but implementation and accountability mechanisms are needed to ensure that children’s rights and experiences are reflected in drug policymaking.
The near invisibility of harms to children and young people due to drug policies is mirrored by the fact that they have had little influence over policies adopted in their name. Article 12 of the CRC gives children the right to express their views in matters affecting them and to have those views given due weight according to age and maturity.[32] Young people can describe how drug education lands in a classroom, whether a service is actually accessible, how policing is experienced, how drug markets and risks are changing locally, and what approaches would work better to prevent exploitation in illicit drug economies. Youth consultations for a new Global Commission on Drug Policy brief focusing on children and young people repeatedly found that participants wanted practical, evidence-based information and a role in policy development.[33] Ireland’s Citizens’ Assembly on Drugs Use offers one example of a structured young people’s consultation feeding into successive stages of policymaking.[34]
At the international level, children and young people have few opportunities to participate meaningfully in drug policy discussions and decision-making. Those affected by criminalization, barriers to harm reduction, family incarceration, or exploitation in drug markets have far less space within that frame, leaving policy makers with less evidence about how children and young people experience drug policy effects on the ground. Importantly, children and young people are not a single constituency, and a process populated only by well-connected youth representatives may reproduce the exclusions it is meant to correct. Young people who use drugs, those affected by criminalization or exploitation, and those from communities heavily exposed to enforcement may need specific support to participate safely and effectively. Meaningful participation requires attention to the intersecting barriers faced by young people, including discrimination linked to drug use, gender, disability, ethnicity, migration status, and socioeconomic circumstances. Consultation processes should be designed to reach those most affected by drug policies, rather than relying exclusively on established youth representation structures.[35]Vitally, young people should be provided pluralistic spaces that allow for this variety of experiences to be discussed, with safeguarding measures in place, therefore moving away from solely prevention-focused participation opportunities for young people and encouraging the voices of all who are impacted by drug policies.
The Global Commission on Drug Policy has recommended a permanent youth advisory mechanism to ensure meaningful involvement in the development, implementation, monitoring, and evaluation of drug policies.[36] The right to be heard does not give children and young people the final word on contested questions of drug policy. It does require institutions to engage with knowledge, experience, and priorities that have been largely absent from international deliberations.
The independent review should also confront the weakness of age-disaggregated data across many domains. A system that invokes the protection of children should be able to identify how many are arrested or detained under drug laws, whether they can obtain essential controlled medicines and health services, and how enforcement affects their families. Specific metrics for tracking drug policy harms to children need to be developed.[37] Data on detention and criminalization, access to services and controlled medicines, family impacts, exploitation, and violence—disaggregated by age and, where appropriate and safe, by sex, disability, ethnicity, migration status, and other relevant characteristics—would reveal discriminatory impacts and dimensions of drug policy affecting children and young people that conventional measures of drug use and supply largely miss.
Child rights impact assessments of drug policies should be systematically conducted to evaluate the potential and actual impacts of drug policies on children’s rights.[38] Assessing drug laws and policies against the CRC, both before and after implementation, would bring their effects on children’s rights—and children’s lives—into routine policy scrutiny. It would also require governments to account for foreseeable consequences rather than treating a protective purpose as sufficient justification.
Conclusion
Ten years after UNGASS promised “a better tomorrow” for youth, children remain prominent in the justification for international drug control and marginal in its governance. The CND resolution record captures a clear imbalance when it comes to children and young people. Prevention has dominated, while detention, pediatric access to controlled medicines, harm reduction, exploitation, and harms arising from drug policy have received little or no sustained attention. Child protection cannot begin and end with drug use prevention. Avoidable pain, unnecessary detention, violence, stigma, family separation, and exclusion from care cannot be treated as incidental when they are foreseeable consequences of policies adopted in children’s name. The independent review is an opportunity to make child rights scrutiny, and the participation necessary to inform it, part of how international drug control judges its own performance.
Anna Tomasi, LLB, LLM, is the executive secretary of the Global Commission on Drug Policy, based in Geneva, Switzerland.
Ruby Rose Lawlor is the executive director of Youth RISE, based in Barcelona, Spain.
Please address correspondence to Anna Tomasi. Email: anna.tomasi@globalcommissionondrugs.org.
Competing interests: None declared.
Copyright © 2026 Tomasi and Lawlor. This is an open access article distributed under the terms of the Creative Commons Attribution-Noncommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original author and source are credited.
References
[1] Authors’ review of CND resolutions adopted between 2000 and 2026. The 19 resolutions identified are CND resolutions 43/4 (2000), 44/5 (2001), 48/10 (2005), 51/2 (2008), 53/2 (2010), 53/10 (2010), 55/10 (2012), 57/2 (2014), 57/3 (2014), 58/2 (2015), 58/3 (2015), 59/6 (2016), 60/7 (2017), 61/2 (2018), 61/9 (2018), 63/4 (2020), 65/4 (2022), 67/2 (2024), and 68/1 (2025).
[2] United Nations General Assembly, Our Joint Commitment to Effectively Addressing and Countering the World Drug Problem, UN Doc. A/RES/S-30/1 (2016).
[3] Commission on Narcotic Drugs, Resolution 68/6: Strengthening the International Drug Control System; A Path to Effective Implementation (2025).
[4] Office of the United Nations High Commissioner for Human Rights, Human Rights Challenges in Addressing and Countering All Aspects of the World Drug Problem, in Particular on the Impact of Drug Policies on the Rights of Women and Girls, UN Doc. A/HRC/63/56 (2026), paras. 51–56.
[5] United Nations Development Programme, World Health Organization, Joint United Nations Programme on HIV/AIDS, et al., International Guidelines on Human Rights and Drug Policy (2019).
[6] Convention on the Rights of the Child, G.A. Res. 44/25 (1989).
[7] Committee on the Rights of the Child, General Comment No. 15, UN Doc. CRC/C/GC/15 (2013).
[8] Single Convention on Narcotic Drugs (1961), as amended by the 1972 Protocol, 976 UNTS 105.
[9] F. M. Knaul, P. E. Farmer, E. L. Krakauer, et al., “Alleviating the Access Abyss in Palliative Care and Pain Relief—an Imperative of Universal Health Coverage: The Lancet Commission Report,” Lancet 391/10128 (2018).
[10] World Health Organization, Integrating Palliative Care and Symptom Relief into Paediatrics: A WHO Guide for Health Care Planners, Implementers and Managers (2018).
[11] J. Downing, F. M. Knaul, X. J. Kwete, et al., “The Global Need for Paediatric Palliative Care: The Evolution of Serious Health-Related Suffering in Children Aged 0–19 Years from 1990 to 2023,” Lancet Child & Adolescent Health 10/3 (2026), pp. 167–178.
[12] Knaul et al. (see note 9); World Health Organization (see note 10).
[13] Commission on Narcotic Drugs, Resolution 67/2: Promoting Awareness-Raising, Education, Training and Data Collection as Part of a Comprehensive Approach to Ensuring Access to and the Availability of Controlled Substances for Medical and Scientific Purposes, Including for the Treatment of Children, and Ensuring Their Rational Use, UN Doc. E/2024/28 (2024).
[14] Office of the United Nations High Commissioner for Human Rights, Human Rights Challenges in Addressing and Countering All Aspects of the World Drug Problem, UN Doc. A/HRC/54/53 (2023).
[15] A. Fletcher and A. Krug, “Excluding Youth? A Global Review of Harm Reduction Services for Young People,” in C. Stoicescu (ed), Global State of Harm Reduction 2012 (Harm Reduction International, 2012).
[16] United Nations Development Programme et al. (see note 5), sec. III(1); Human Rights Council, Drug Use, Harm Reduction and the Right to Health: Report of the Special Rapporteur on the Right to Health, UN Doc. A/HRC/56/52 (2024); Office of the United Nations High Commissioner for Human Rights (2026, see note 4); Committee on the Rights of the Child, Concluding Observations on the Combined Third and Fourth Periodic Reports of Qatar, UN Doc. CRC/C/QAT/CO/3-4 (2017).
[17] United Nations General Assembly, Global Study on Children Deprived of Liberty, UN Doc. A/74/136 (2019).
[18] UNICEF, Estimating the Number of Children Deprived of Liberty in the Administration of Justice (2021).
[19] Ministry of Human Rights and Citizenship (Brazil), Levantamento Nacional de Dados do SINASE – 2023 (2023).
[20] Human Rights Council, Arbitrary Detention Relating to Drug Policies: Study of the Working Group on Arbitrary Detention, UN Doc. A/HRC/47/40 (2021).
[21] C. Giacomello, Childhood That Matters: The Impact of Drug Policy on Children with Incarcerated Parents in Latin America and the Caribbean (Church World Service, 2019).
[22] Pregnancy Justice, Parenting and Drug Use: Pregnancy, Parenting and Criminalization (2022).
[23] United Nations General Assembly, Guidelines for the Alternative Care of Children, UN Doc. A/RES/64/142 (2010); Convention on the Rights of the Child (see note 6), arts. 9, 18.
[24] Inter-American Commission on Human Rights, Northern Central America: Organized Crime and the Rights of Children, Adolescents and Young People, OEA/Ser.L/V/II, Doc. 51/23 (2023).
[25] K. Tollin, H. Angerbrandt, and A. Jonsson, Children and Youth in Criminal Networks: Network Entry, Offending, Conditions, and Network Exit (Swedish National Council for Crime Prevention, 2025).
[26] Office of the United Nations High Commissioner for Human Rights (2023, see note 14); Expert Mechanism to Advance Racial Justice and Equality in Law Enforcement: Report to the Human Rights Council, UN Doc. A/HRC/63/72 (2026).
[27] United Nations Security Council, Resolution 2427, UN Doc. S/RES/2427 (2018); Inter-American Commission on Human Rights, Resolution 1/26: Organized Crime and Human Rights (2026).
[28] Commission on Narcotic Drugs, Resolution 61/9: Protecting Children from the Illicit Drug Challenge, UN Doc. E/2018/28 (2018).
[29] Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, 1582 UNTS 95 (1988), preamble, art. 3.
[30] Convention on the Rights of the Child (see note 6), arts. 37(b), 40.
[31] Office of the United Nations High Commissioner for Human Rights, Study on the Impact of the World Drug Problem on the Enjoyment of Human Rights, UN Doc. A/HRC/30/65 (2015); Office of the United Nations High Commissioner for Human Rights, Implementation of the Joint Commitment to Effectively Addressing and Countering the World Drug Problem with Regard to Human Rights, UN Doc. A/HRC/39/39 (2018); Office of the United Nations High Commissioner for Human Rights (2023, see note 14); Office of the United Nations High Commissioner for Human Rights (2026, see note 4).
[32] Convention on the Rights of the Child (see note 5), art. 12.
[33] Global Commission on Drug Policy, Making Children and Young People Visible in Drug Policy: A Child Rights-Based Agenda for Reform (2026), consultation findings.
[34] A. Egan, Report on the Consultations with Young People for the Citizens’ Assembly on Drugs Use, November 2022–March 2023 (Department of Health – Ireland, 2023).
[35] Office of the United Nations High Commissioner for Human Rights (2023, see note 14).
[36] Global Commission on Drug Policy (see note 33), recommendation 10.
[37] Ibid., recommendation 11.
[38] Ibid., recommendation 11.