By Enjema Ngende
In the heart of Africa, countless parents embark on a relentless quest, moving from pillar to post in search of hope for their children. These young people, caught in the grip of substance abuse and addiction, often go unseen and untreated. Parents navigate a landscape where interventions are scarce, misunderstood, or too expensive, making access to help rare and difficult. Each success story shows resilience, but also highlights how much more needs to be done to make prevention and treatment available and effective for all adolescents and young adults.
Recent data show that South Africa faces rising use of cocaine, opioids, and cannabis. In Sierra Leone, the synthetic drug “kush” prompted public health alerts due to its extreme potency. In Cameroon, the most commonly abused substances among youth and adults include alcohol, cannabis, tramadol, cocaine, and, to a lesser extent, heroin and solvents. In Ghana and other West African nations, substance use disorders among youth are increasing, with projections indicating a significant rise by 2030. These trends reflect a continent-wide challenge that demands urgent, coordinated action.
Substance abuse is a growing public health challenge
In Africa, it is often seen as a moral failing, creating shame that prevents people from seeking help. Yet research shows that addiction is far more complex, shaped by biology, trauma, economic stress, and a lack of support.
The continent’s young population, combined with rapid urbanization, youth unemployment, conflict, displacement, and untreated mental illness, heightens vulnerability to harmful substance use.
Stigma compounds the problem. A Nigerian mental health counselor observes, “Limited mental health education and awareness, along with shame and stigma, are major barriers here in Nigeria. People struggling with mental illness often get labeled, teased, or even punished by their families and communities.” Research from Ethiopia highlights similar struggles, showing that stigma and exclusion are a daily reality for people with mental health conditions. Experts emphasize that efforts to fight stigma must go hand in hand with improving local access to mental health care, so people can actually get the support they need.
A whole-of-society approach
Addressing substance abuse requires a whole-of-society approach, engaging families, schools, communities, digital platforms, and health systems. Prevention, treatment, and reintegration must operate in tandem, meeting young people where they are, including in online spaces where social interaction, peer influence, and exposure to substances are increasingly mediated.
Infrastructure gaps and the workforce shortage. Across Africa, substance abuse and addiction treatment are constrained by severe shortages of qualified mental health professionals. Cameroon has an estimated 0.03 psychiatrists per 100,000 people. Nigeria, with over 220 million residents, has fewer than 300 practicing psychiatrists, concentrated in major cities. Specialists in substance abuse treatment are even rarer.
For families, this shortage translates into long travel distances, extended waiting times, and prohibitive costs. Public hospitals are overwhelmed, mental health units are underfunded, and rehabilitation centers are often private, faith-based, or informal, with widely variable quality. Insurance coverage for substance abuse treatment is minimal or nonexistent.
Substance abuse care is often narrowly medicalized, tied primarily to psychiatry. Yet effective intervention requires community-based rehabilitation, psychosocial support, long-term recovery pathways, family reintegration programs, harm-reduction strategies, and early prevention and screening. Without these systems, relapse and repeated crises are inevitable.
The cost of neglect
Untreated substance abuse and addiction exact a high social and economic toll. Families lose breadwinners. Young people drop out of school. Communities experience rising violence, homelessness, and incarceration. Health systems absorb preventable emergencies, and economies lose productivity.
Despite this, substance abuse remains one of the least prioritized health concerns. Governments, on average, allocate less than 1% of national health budgets to mental health. Substance abuse, sitting at the intersection of public health, social welfare, and public safety, consistently falls through systemic cracks.
Decolonizing substance abuse care. Current mental health systems reflect colonial-era designs, which prioritized institutionalization over community care, pathology over prevention, and centralized expertise over local capacity. These frameworks fail to meet African realities and do not adequately address substance abuse.
Decolonizing care involves recognizing substance abuse and addiction as medical and social conditions, designing community-based solutions rooted in local contexts, scaling up training for African mental health professionals, expanding care to include counselors, social workers, and peer-support systems, and funding African-led research on substance abuse patterns, treatments, and prevention.
Meeting young people where they are
Digital engagement is critical. Social media platforms, mobile technology, and online communities offer new pathways for prevention, counseling, peer support, and early intervention. Programs designed to reach youth in their digital spaces can complement clinical services and expand access where physical infrastructure is limited.
A comprehensive response must integrate health education, early screening, harm reduction, family support, and community engagement. This whole-of-society framework ensures interventions are culturally relevant, accessible, and sustainable.
Policy and government action. African governments must treat substance abuse intervention as core national infrastructure, as critical as energy, transport, and digital systems. This requires sustained public investment, policy integration, and protective legislation that safeguards patients and families. Investment in substance abuse care is not charity; it is strategic, supporting public health, social stability, and economic productivity.
Governmental action should include scaling up rehabilitation centers, integrating mental health services into primary care, funding workforce development, supporting community-based programs, and ensuring equitable access to care. Policy frameworks must align with contemporary realities rather than outdated colonial models that fail to address African youth populations.
From crisis to care
Global partnerships. International funders, philanthropic institutions, and development partners also have a role to play. Too often, mental health and substance abuse are deprioritized relative to more visible diseases, despite their profound societal impact. Supporting African-led research, capacity building, and community-based interventions is not charity, it is evidence-based public health practice.
True partnership requires shifting power, funding structures, and technical support to African institutions. Investing in local expertise ensures interventions are contextually appropriate, sustainable, and ethically grounded.
Many young people navigating substance abuse and addiction face fragmented, under-resourced systems. Recovery is possible but depends on coordinated, adequately funded, stigma-free pathways. Substance abuse is not a personal failure; it is a collective responsibility. Africa must build systems that transform desperation into care, stigma into support, and silence into action.
The continent is not facing a future substance abuse crisis; it is facing one now. The question is whether governments, communities, and global partners will act decisively or continue to leave millions without care. Responding to substance abuse and addiction is no longer optional. It is a public health imperative, central to Africa’s social and economic development.
