Adolescents and young adults (AYAs, 14–24 years old) have the highest rates of drug use in most low- and middle-income countries. Joseph D. Tucker, MD, PhD, AM, performed a secondary data analysis of the baseline survey of the ‘I-TEST’ study involving AYAs in Nigeria. The two primary outcomes of interest were lifetime measures of drug use and needle sharing. Researchers concluded drug use and needle sharing are common among AYA in Nigeria. There is an urgent need for harm reduction services and research informed by AYA.