A practical, fact-based guide for young people leading substance use prevention and harm reduction conversations in their communities.
Designed PDF edition coming soon to the publications library
This toolkit is written for youth advocates who want to make a real difference in their communities by sharing accurate, non-judgmental information about drugs and harm reduction.
Whether you are a peer educator, a student leader, a community health worker in training, or simply someone who cares about the young people around you, this toolkit gives you the knowledge and language you need to have honest conversations about substance use.
Core Approach: Non-Judgmental, Fact-Based. Fear, shame, and scare tactics do not work. Research consistently shows that young people respond better to honest, accurate information delivered with respect and empathy.
Harm reduction is a public health approach that aims to reduce the negative consequences of drug use, without requiring abstinence as the only acceptable outcome.
Harm reduction does not mean we encourage or promote drug use. It means we are realistic: some young people will use substances regardless of what we say, and our job is to keep them as safe as possible. Think of it like wearing a seatbelt. We do not encourage car crashes, but we know crashes happen, so we use seatbelts to reduce injury. Harm reduction is the seatbelt for substance use.
Drug use exists in every community. Denial does not protect people; information does.
People who use drugs deserve dignity and respect. We offer help without attaching conditions or shame.
Staying alive and healthy today is the first priority. Reducing use, and then stopping, may come later.
Those who use substances are experts on their own lives. Effective harm reduction involves them in finding solutions.[1]
Poverty, violence, unemployment, trauma, and stigma all drive substance use. Harm reduction tackles root causes, not just symptoms.
Effective harm reduction in Africa must be rooted in local realities, languages, and community values, not copied wholesale from Western models.[2]
Every recommendation in harm reduction is backed by scientific research, not opinion, ideology, or moral judgment.
| Level | What It Looks Like | Example in Practice |
|---|---|---|
| Prevention | Stopping first use | Peer education workshops in schools |
| Reducing Harm | Making use safer if it happens | Not mixing substances; never using alone |
| Early Intervention | Catching problematic use early | ASSIST screening, brief counselling |
| Treatment & Recovery | Helping people reduce or stop use | Referral to SANCA, government rehab |
| Reintegration | Supporting people after treatment | Community support groups; life skills programs |
Understand the landscape before you advocate. These numbers show why harm reduction in Africa is urgent and why young people must lead the response.
| Substance | Lifetime Use | Current Use | Notes |
|---|---|---|---|
| Alcohol | 36.2% | 23.6% | Most prevalent; highest in Southern Africa |
| Khat | 23.0% | 17.3% | Especially common in East Africa |
| Tobacco/Cigarettes | 15.2% | 11.8% | Southern & East Africa |
| Opioids | 15.9% | , | Includes nyaope/whoonga in SA |
| Steroids | 12.2% | , | Higher among young males |
| Cannabis | 11.0% | 3.7% | Most prevalent illicit drug in SA |
| Sedatives | 8.9% | , | Often misused prescription drugs |
| Shisha | 8.4% | , | Urban centres |
| Inhalants | 6.0% | , | Common among 10-14 age group |
| Cocaine | 3.0% | , | Urban coastal cities |
Source: Frontiers in Psychiatry systematic review, 2024, 60 studies, 83,859 respondents aged 10-24 across SSA.[4]
| Reason | What It Tells Us as Advocates |
|---|---|
| Stress relief & escape | Address mental health and offer alternative coping tools |
| Peer pressure & fitting in | Build peer refusal skills; normalise saying no |
| Curiosity & experimentation | Give accurate info early, before first use |
| Boosting confidence or energy | Explore what needs are unmet beneath this |
| Self-medication (pain, trauma, anxiety) | Link to mental health and trauma-informed support |
| Easy access & availability | Advocate for better community regulation and safe spaces |
Source: Frontiers in Psychiatry, 2024.[4]
Who Is Most at Risk? Research shows the following factors are associated with higher risk among African youth:[4]
Accurate knowledge is your most powerful tool. Below are profiles of the most common substances affecting youth in South Africa and the wider region.
Risk levels: HIGH RISK = strong dependence, severe health damage, or overdose risk. MEDIUM RISK = significant risk, especially with heavy or combined use. LOWER RISK does not mean safe, all substance use carries some risk.
Use this section in workshops, classroom sessions, or social media campaigns. Read the MYTH first and ask participants what they think. Then reveal the FACT.
Weed is natural, so it can't harm you.
Many natural substances are harmful, arsenic and many medicinal herbs can cause serious damage. Cannabis can impair brain development in teenagers, trigger psychosis in vulnerable individuals, and cause lung damage when smoked. "Natural" does not mean safe.[4]
You can't get addicted to alcohol, it's legal.
Alcohol is one of the most addictive substances in the world. Legal status has nothing to do with harm. Alcohol causes more deaths, violence, and disease burden in South Africa than all illegal drugs combined.[5] Dependence can develop in as little as a few months of regular heavy use.
Harm reduction means encouraging drug use.
Harm reduction does not promote drug use. It is a public health strategy that accepts the reality that some people use substances, and focuses on keeping them alive and healthy. Evidence shows harm reduction reduces HIV transmission, overdose deaths, and overall harm, without increasing drug use.[1]
Only weak or bad people become addicted.
Addiction is a complex health condition, not a character flaw. Genetics, trauma, mental health conditions, peer environment, and early age of first use all play major roles. Stigmatising people who are addicted prevents them from seeking help and makes the problem worse.[4]
Vaping is harmless, it's just water vapour.
Vape aerosols contain nicotine, heavy metals (like lead and nickel), and other toxic chemicals. Vaping has been linked to serious lung disease and is highly addictive. It is particularly dangerous for adolescents whose lungs are still developing.
Mixing drugs with alcohol just makes them work faster. Not a big deal.
Mixing substances ("polydrug use") dramatically increases the risk of overdose, respiratory failure, heart attack, and death. Alcohol plus depressants (like sleeping pills or nyaope) can stop your breathing. Alcohol plus stimulants (like tik) masks intoxication, leading to dangerously high consumption of both.
Drug education is only for people who are already using.
Over 42% of South African young people currently use at least one substance.[4] Even if you personally do not use, the people you love, study, or live with likely need accurate information. Knowledge protects entire communities, not just individuals.
If someone passes out from drinking, just let them sleep it off.
A person who has passed out from alcohol can die from choking on their vomit or from alcohol poisoning. Place them in the recovery position (on their side), monitor their breathing, and call emergency services if you cannot wake them or if breathing is irregular. Never leave them alone.
Do not reveal the answer yet.
"True or False? What do you think, and why?"
Allow 2-3 responses without judgment.
Read the fact and discuss it together.
Ask: "Did this change what you thought? What would you do differently now?"
Practical, evidence-based strategies for reducing harm if a young person is already using. You can share these facts without encouraging use.
| Strategy | Why It Matters |
|---|---|
| Never use alone | If something goes wrong, someone can call for help and perform first aid. |
| Start low, go slow | Tolerance varies between people. Unknown strength is dangerous. |
| Never mix substances | Polydrug use multiplies risk of overdose and other harms dramatically. |
| Know what you're taking | Street drugs are frequently adulterated. Fentanyl contamination has been detected in South African drug supplies. |
| Stay hydrated | Especially with stimulants, but do not over-hydrate, which can also be dangerous with certain substances. |
| Avoid use when distressed | Emotional state strongly affects the experience. Using when very anxious or depressed increases risk. |
| Do not share needles or equipment | Prevents transmission of HIV, hepatitis B and C, and other blood-borne infections. |
| Plan your journey home | Never drive under the influence. Arrange transport in advance. |
The most important skill you have as an advocate is not your knowledge, it is how you communicate. Effective peer conversations are non-judgmental, curious, and solution-focused.
| Avoid This | Try This Instead |
|---|---|
| "How could you be so stupid?" | "What was going on for you at the time?" |
| "You need to stop immediately." | "What would need to change for you to feel safer?" |
| Threatening to tell parents/teachers | Ask permission before involving others unless there is risk to life |
| Sharing their story with friends | Keep what they share private unless consent is given |
| "It's not that bad." | Take every disclosure seriously, even if the use seems minor |
In an emergency, calm, quick action saves lives. Every young advocate should know these basics.
| Substance Type | Warning Signs, Call 112 Immediately |
|---|---|
| Depressants (alcohol, heroin/nyaope, sleeping pills) | Unconscious or barely awake; very slow or irregular breathing; blue-grey lips or fingernails; will not respond to voice or touch; gurgling sounds |
| Stimulants (tik, cocaine, MDMA) | Chest pain; very rapid heart rate; dangerously high temperature; seizures; severe confusion or aggression |
| Inhalants | Collapsed suddenly; irregular heartbeat; not breathing; unconscious after inhalation |
| Cannabis / General | Severe panic attack with chest pain; extreme confusion; loss of consciousness |
Check that the scene is safe. Do not put yourself at risk.
Call their name. Tap their shoulders firmly. If no response, call 112 immediately.
Tilt their head back gently and lift their chin to open the airway.
Look, listen, and feel for breathing for up to 10 seconds. If not breathing, begin CPR if trained.
If a pulse is present but breathing is absent, give rescue breaths. Stay with the person until emergency services arrive.
Position yourself close, ready to move them.
Elbow bent, palm facing up.
Hold the back of their hand against their nearest cheek.
So the foot is flat on the floor.
Pull on the bent knee to roll them onto their side toward you.
Keep the airway open.
Never leave them alone until help arrives.
You cannot pour from an empty cup. Advocacy work around substance use and trauma is emotionally demanding. Protecting your own wellbeing is not optional, it is essential.
| Dimension | Practical Actions |
|---|---|
| Physical | Protect sleep, eat regularly, move your body. Chronic stress depletes the body first. |
| Emotional | Debrief with a trusted mentor or peer after difficult conversations. Journal. Name your feelings. |
| Social | Maintain friendships outside of advocacy work. Have people in your life who do not see you as an advocate first. |
| Boundaries | Set clear times for advocacy and clear times for rest. Switch off notifications. You are not on call 24/7. |
| Purpose | Reconnect regularly with why you started. Celebrate small wins, a good conversation, a new person reached. |
| Professional | Seek supervision or coaching from a trained mentor. Know when to step back temporarily. |
Always have these contacts ready. Save them to your phone. When someone is ready to reach out for help, that window can be small, be prepared to act quickly.
| Service | Number |
|---|---|
| All emergencies (mobile) | 112 |
| Ambulance | 10177 |
| Police | 10111 |
| Childline (under 18, free) | 116 |
| SANCA Substance Abuse Helpline | 0800 12 13 14 |
| Stop Gender Violence Helpline | 0800 428 428 |
Social Media Advocacy Guide
Social media is one of the most powerful tools youth advocates have. The African Union recommends developing digital toolkits and youth-friendly campaign materials across African countries.[3]
Posts that shame or lecture get scrolled past. Posts that speak to lived experience get shared.
Do not try to cover everything. One fact. One tip. One question.
Credibility is your biggest asset. Cite health organisations, government data, or peer-reviewed research.
Suggested hashtags for African harm reduction campaigns: #HarmReductionAfrica, #SSDP, #YouthHealthZA, #KnowBeforeYouGo, #SayItWithFacts, #AfricaYouthRise, #RehabilitationNotStigma, #SensibleDrugPolicy