This article is a study of the experiences of young people around the world when accessing harm reduction services. These services include syringe access programs, opiate substitution therapy, sexual health services, and health education. People were eligible to participate if they were 18 to 30 years old and reported injecting drugs before the age of 18. Researchers conducted 19 group interviews with 132 participants in 14 countries.

Participants reported several barriers to accessing harm reduction services. Organizational or societal obstacles (known as “structural barriers”) included age restrictions on accessing services, illegality of substance use, cost, and distance from home. Social barriers included possible identification as a person who injects drugs, and reliance on their partners for injection equipment among female participants.

Participants also mentioned other issues such as a lack of youth-friendly services and not knowing where or how to access services. Groups also shared that youth believed they did not need services because they hadn’t experienced negative consequences related to their drug use. Finally, the need for services outside of harm reduction—such as employment, legal, education, and support for street-involved youth—were highlighted among study participants.