Research consistently links mental health challenges during youth with a higher risk of turning to substance use as a coping mechanism. According to the World Drug Report (2020), the United Nations Office on Drug Control (UNODC), there is a strong link between substance use disorder (SUD) and co-occurring mental health conditions, suggesting that they share common underlying risk factors that contribute to the development of both SUD and mental health conditions. A youth-centered, evidence-based approach is what Zimbabwe needs to prevent this public health crisis from further claiming lives and the untapped potential of young people.
Understanding the Crisis in Zimbabwe
Drug and substance use among adolescents and young people has increased at an alarming rate in Zimbabwe, and evidence-based approaches are critical to making informed, actionable policies to address this crisis.
In Zimbabwe, the most commonly misused substances include glue, Broncleer (prescription cough syrup with alcohol and codeine), mangemba (homemade drink laced with chlorpromazine, diazepam, and other drugs meant for the treatment of disorders), cane spirit, marijuana, codeine, and methamphetamine, commonly known by Zimbabweans as “mutoriro.”
Like many countries, escalating rates of substance use disorder in Zimbabwe were further exacerbated by the COVID-19 pandemic. During lockdowns, unprecedented numbers of young people turned to substance use. Studies from the Zimbabwe Civil Liberties and Drug Network (ZCLDN) and the Munthengo Development Solutions (MDS) have also confirmed that 10 to 18-year-olds were particularly vulnerable to SUD during this time.
A World Health Organization (WHO) report from 2019 also identified Zimbabwe as having the highest rate of “episodic” (or binge) drinking among 15- to 19-year-olds in Africa, accounting for 70.7% of males and 55.5% of females who were studied.
These alarming trends reflect the need for urgent comprehensive public health policies and legislative interventions across the SUD continuum of care to ensure access to quality, evidence-based prevention, harm reduction, treatment, and recovery programs as tools to curb the substance use crisis and protect adolescents.
Zimbabwe’s Response to the Crisis Before the MSDSAP
Zimbabwe’s response to substance use has historically focused on punitive measures. Section 157 of Zimbabwe’s Criminal Law Codification and Reform Act criminalizes substance use and incarcerates people who possess or use drugs for up to five years, regardless of the quantity of drugs. Such measures keep young people out of school, which can offer diversion and deflection programs to keep them out of jails and prisons. In 2021, the government adopted the National Drug Master Plan, which outlines a framework that includes a reduction in supply and demand, promotion of harm reduction treatment, rehabilitation, and community reintegration. Despite these efforts, substance use among young people in Zimbabwe continues to rise alarmingly, pointing to the need for more than just a framework, but an action plan with comprehensive, responsive strategies. Another significant challenge has been the disconnect between policy and practice, likely due to the lack of resources allocated for implementation. This can be solved by establishing a well-coordinated, multi-sectoral action plan that not only allocates sufficient resources but also ensures effective implementation and monitoring. This should also include collaboration between government, community organizations, and stakeholders, focusing on evidence-based interventions, continuous evaluation, and the adaptability to respond to emerging challenges in the substance use space.
What is Zimbabwe’s New Strategy?
In 2016, the United Nations recognized the importance of a comprehensive, multi-sectoral approach to address the health-related aspects of the global drug issue, including public health, law enforcement, education, and social policy. In response to the escalating crisis, the President of Zimbabwe launched The Zimbabwe Multisectoral Drug and Substance Abuse Plan (MSDSAP) in July 2024. This plan approaches SUD as a complex public health, social, economic, and national security challenge, with the goal of improving the overall health and well-being of the Zimbabwean people.
With the introduction of this new plan, Zimbabwe builds on its master plan with actionable strategies and a multi-sectoral approach to achieving its goals. The MSDSAP allows for different sectors to leverage existing resources, coordinate funding streams, and improve data sharing. The plan also includes significant prioritization of the youth population. This approach, within the broader, nationwide action plan, has the potential to address the unique, holistic needs of young people and to disrupt isolated information cycles by fostering collaboration among various sectors, leading to more comprehensive support systems and improved outcomes for young people in Zimbabwe.
The MSDSAP’s strategic pillar, “Demand Reduction,” focuses on preventing and delaying the first use of substances — both illicit, such as drugs, and legal, such as alcohol — among children and young people. It aims to reduce the demand for and non-medical use of prescription drugs through youth-centered prevention and treatment strategies. The MSDSAP focuses on the prioritization of mental health and engagement programs for young Zimbabwean people who are living in communities heavily impacted by the substance use public health crisis.
Expulsion from school for substance use has been on the rise in Zimbabwe, as highlighted in a study conducted by UNICEF in collaboration with the government, Muthengo Development Studies (MDS), Zimbabwe Civil Liberties and Drug Network (ZCLDN), and Youth Advocates Zimbabwe (YAZ). The study found that the number of school dropouts increased, with 60% of people having dropped out of school following expulsion for drug and substance use. In January 2023, one school was reported to have expelled 8 girls from the institution due to drug-related incidents. To address this issue, the MSDSAP includes a pillar on strategic interventions to promote and screen for mental health and substance use issues in young people in educational settings. The pillar proposes building workforce capacity by training school staff on early identification and evidence-based handling of substance use cases in schools. Additionally, institutions have been taking steps to increase access to screening services, such as the Abused Substances and Diagnostic Management project launched by the University of Zimbabwe.
The MSDSAP also seeks to strengthen evidence-based responses across the continuum of care, harm reduction, treatment, and rehabilitation. These strategies include building and strengthening public health system infrastructure and workforce, training primary caregivers to provide quality frontline treatment, and distributing cost-effective harm reduction supplies to harm reduction organizations. Enhanced collaboration among these sectors can lead to better resource utilization, improved access to services, and more robust and resilient public health systems for individuals and communities affected by substance use. Since the launch of Zimbabwe’s National Drug Master Plan in 2021, the four public health institutions addressing SUD and mental health challenges have yet to be upgraded to meet the increased demand or adequately cater to the unique needs of youths facing this crisis. However, because the MSDSAP adopts a multisectoral approach to SUD with the potential for new investments in behavioral health care systems, there could be a renewed hope for Zimbabwean youth impacted by the substance use health crisis.
For the young people affected by the substance use health crisis, the plan emphasizes the importance of community reintegration and community support programs and services, including employment and economic strengthening opportunities for adolescents and young people. These efforts are meant to address the social determinants of health, which are critical for ensuring effective and sustainable recovery. By tackling these underlying social factors, the plan seeks to reduce stigma and discrimination to create a supportive environment that not only facilitates recovery but also empowers young individuals to build resilient and healthy futures.
How Does Zimbabwe’s Plan Compare to the United States?
Provisional data from the Centers for Disease Control and Prevention estimates that drug overdose deaths in the United States declined by 3% in 2023— the first decrease in annual drug overdose deaths since 2018. However, the number of American lives lost to the overdose epidemic in 2023 still exceeded 100,000. The National Institute on Drug Abuse’s 2023 data showed that trends in the use of illicit drugs among young people have remained stable or declined, while other research reported a dramatic rise in overdose deaths among teenagers between 2010 to 2021. According to the 2023 United States National Survey on Drug Use and Health, 17.1% of Americans aged 12 and older had an SUD in the past year, with commonly used drugs, including marijuana, misused opioids (heroin or prescription opioids), and fentanyl.
The Biden Administration’s Office of the National Drug Control Policy (ONDCP) released the 2024 National Drug Control Strategy, outlining a framework to address SUD that includes increased access to treatment, promotion of harm reduction, and criminal justice reform. In addition, the strategy aims to expand evidence-based prevention efforts to address a variety of health and socioeconomic factors, such as mental health, education, housing, employment, and health inequities, which can contribute to or co-present with adolescent substance use. In 2022, the ONDCP announced $12.4 million in grants for 99 new community coalitions through the Drug-Free Communities Support Program to support President Biden’s Strategy and prevent youth substance use, including prescription drugs, marijuana, tobacco, and alcohol. These federal funds have translated to coalition efforts across all states to ensure that the program grants are being utilized to effectively combat the issue.
Groups and institutions are starting to recognize the special factors that affect youth and SUD. Evidence-based and school-based prevention programs, such as Project Towards No Drug Abuse (Project TND), developed by the University of Southern California, have been implemented in the United States to help high-risk students aged 14-19 years old resist substance use. In a randomized trial, Project TND participants showed a 25% reduction in “hard” drug use and a 7-12% decrease in alcohol use among prior users compared to control groups at one-year follow-up, underscoring the program’s effectiveness.
Pathways to Progress
Progress on the MSDSAP hinges on fostering a whole-of-government and whole-of-society approach that integrates public health, law enforcement, education, and community-based interventions. Collaborative efforts across sectors will strengthen prevention, treatment, and recovery initiatives, ensuring sustainable solutions to the addiction and substance use crisis. Aspirations of the MSDSAP mirror that of the United States’ Drug Control strategy, with both promoting harm reduction, treatment, criminal justice reform, and a person-centered approach to substance use. The United States has invested billions of dollars to address the growing and evolving overdose crisis. To achieve their goals, the responsible authorities in Zimbabwe, including the National Drug Agency proposed by the MSDSAP, should similarly manage and administer funds across the SUD continuum of care, with an eye toward youth-responsive support and services as well as recovery.
Data collection and reporting should be prioritized as a way to hold systems and institutions accountable and better understand the areas of urgent need and emerging trends. The MSDSAP is a stepping stone for various stakeholders across different sectors to solidify their efforts to keep young people away from drugs, increase access to treatment, and enhance recovery systems. Private organizations and entities need to partner with and assist the responsible bodies with prevention, treatment, harm reduction, and recovery — whether through policy implementation or strategic interventions — to safeguard the futures of young people of Zimbabwe.
Conclusion
Young people have a critical role to play as advocates for quality, comprehensive, evidence-based SUD services and support. Navigating SUD in the age of social media presents very different challenges from those policymakers have experienced, making the youth perspective essential in understanding their needs and what it takes to achieve recovery. Now is the time for policymakers, researchers, educators, people with lived experience, and other stakeholders to come together to address the substance use crisis. Too often, youth prevention programs are overlooked until the crisis hits close to home and it’s a loved one who is affected. We cannot wait and must contribute now in our different capacities to combat this crisis and secure a healthier future for our youth.
DISCLAIMER: The views and opinions expressed in this piece are those of the author and do not reflect the views of the O’Neill Institute.
