alCoHol and druG use

Alcohol and drug use among children and adolescents are causes of increasing concern in South Africa. They are major contributors to crime, violence and intentional and unintentional injuries, as well as to other social, health and economic problems. This Chapter focuses on children, including adolescents, up to the age of 18 years. Children’s and adolescents’ substance use can be accounted for by a multiplicity of factors at the societal, community, school, familial and individual levels. A combination of universal, selected and indicated intervention strategies are needed to prevent their substance use problems. In addition, effective specialist services, although inadequate in South Africa, are essential for treating young people who already have substance use disorders. While there is much evidence regarding regulatory interventions that are most effective in reducing substance use problems, many barriers to their implementation exist. Further research to improve understanding of various aspects of young people’s substance use and its relationship to crime and violence is needed. Of particular importance are more studies that can shed further light on the factors that constitute protective factors for substance use, and the kind of non-regulatory strategies that can be effective in reducing levels of substance use among children and adolescents in South Africa. keywords: substance use, children and adolescents, prevention strategies INTRODUCTION The use of psychoactive substances by children and adolescents globally and in South Africa is of major concern, particularly, given young people’s increased access to legal and illegal substances, increases in rates of use of certain drugs, and resultant unintentional and intentional injuries and other problems (Flisher, Mathews, Mukoma & Lombard, 2006; Jernigan, 2001; Parry et al., 2004b). Globally, based on 2004 figures, an estimated 3.8% of all deaths were attributable to alcohol (with 6.3% for men and 1.1% for women; Rehm et al., 2009). Of all alcohol-related deaths among men, 27.3% and 11.4% were attributable to unintentional and intentional injuries, respectively, and among females, the figures were 24.8% and 9.0%, respectively. Rehm et al. (2009) estimated the global alcohol-attributable 14