As the world commemorates the International Day Against Drug Abuse and Illicit Trafficking, attention often focuses on individuals who use drugs, alcohol, and tobacco. Yet, another group silently bears the consequences of substance abuse vulnerable children who are homeless, in informal settlements, and in Internally Displaced Persons (IDP) camps. These children may not be using substances themselves, but they are frequently exposed to smoking, alcohol abuse, and drug use by adults and older youths around them. The effects of such exposure extend far beyond physical health and can have profound psychological and emotional consequences (1).
For many vulnerable children, exposure to substance abuse is a daily reality. They witness intoxicated adults, observe risky behaviours, and often live in environments where smoking and drinking are normalized. Research has shown that children learn behaviours by observing those around them, especially adults and older peers. When substance use becomes part of their everyday environment, children may begin to perceive it as an acceptable way to cope with stress, hardship, or emotional pain (2).
Street-connected children are particularly vulnerable. A systematic review involving 50 studies from 22 countries found that substance use is highly prevalent among street children, with an estimated lifetime prevalence of 60%. The review also identified tobacco, alcohol, and inhalants as commonly used substances among this population (2). While these findings focus on substance use among street children, they also highlight the environments in which many vulnerable children’s live environments where exposure to substance abuse is widespread and often unavoidable.
Children who regularly encounter drunken behaviour, substance-related conflicts, neglect, or aggression may experience persistent fear, anxiety, stress, and emotional insecurity. Such experiences can undermine a child’s sense of safety and stability, both of which are essential for healthy emotional development (3).
Children living in IDP camps face additional challenges. Many have already experienced displacement, loss of family members, violence, disruption of education, and uncertainty about the future. Exposure to substance abuse in these settings can compound existing trauma and increase the risk of psychological distress. Mental health experts have consistently noted that repeated exposure to stressful and unsafe environments during childhood can affect emotional regulation, concentration, learning ability, and social relationships later in life (3).
Research among street-living children has also shown that lack of family attachment, exposure to adult substance users, and psychosocial stress are strongly associated with substance use and poor mental well-being among children and adolescents (4). When children grow up surrounded by substance abuse, they may become more susceptible to depression, low self-esteem, behavioural problems, and future substance use themselves.
The effects are not only psychological. Children exposed to second-hand smoke face increased risks of respiratory infections, asthma, impaired lung development, and other health complications. Emerging research also suggests that exposure to tobacco smoke during childhood may affect cognitive development and contribute to learning and behavioural difficulties (5). For vulnerable children already facing multiple hardships, these additional health burdens can further limit their opportunities to thrive.
Perhaps most concerning is that many of these children remain invisible in public health discussions. While humanitarian responses often prioritize food, shelter, and healthcare, the mental and emotional well-being of children exposed to substance abuse frequently receives less attention. Yet mental health is just as important as physical health. A child who lives in constant fear, uncertainty, or emotional distress may carry those experiences into adolescence and adulthood.
Protecting vulnerable children requires a holistic approach. Safe spaces, mental health support services, positive role models, child protection mechanisms, and substance abuse prevention programmes are all critical. Communities must also recognize that substance abuse does not only harm the user; it affects everyone around them, especially children who depend on adults for safety, guidance, and care.
As we observe the International Day Against Drug Abuse and Illicit Trafficking, let us remember the forgotten victims of substance abuse. Street-connected children and children living in IDP camps deserve more than survival. They deserve safe environments that nurture their mental health, protect their well-being, and allow them to reach their full potential.
Protecting children from the hidden effects of substance abuse is not only a public health responsibility it is a moral obligation. Every child deserves the opportunity to grow up free from fear, free from harmful influences, and full of hope for the future.
Governments, humanitarian organizations, community leaders, and families must work together to reduce substance abuse in environments where vulnerable children live. Investments in child protection, mental health services, psychosocial support, and substance abuse prevention programmes can help break cycles of vulnerability and create healthier futures for children. By protecting children today, we strengthen the well-being of future generations.
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References
- Street Children and Drug Abuse. JAMA.
https://jamanetwork.com/journals/jama/article-abstract/1738906 - The Epidemiology of Substance Use Among Street Children in Resource-Constrained Settings: A Systematic Review and Meta-analysis.
https://pmc.ncbi.nlm.nih.gov/articles/PMC3776018/
(PMC) - Protocol for an Observational Study on the Effects of Paternal Alcohol Use Disorder on Children’s Later Life Outcomes.
https://arxiv.org/abs/2412.15535
(arXiv) - Sociodemographic and Psychosocial Correlates of Substance Abuse Among Street Children: A Cross-Sectional Survey in Kolkata, India.
https://pubmed.ncbi.nlm.nih.gov/34322422/
(PubMed) - Research on Childhood Exposure to Second-Hand Smoke and Cognitive/Health Outcomes.
https://www.sciencedirect.com/science/article/pii/S0160412024007918
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