The Isle of Man is "awash with drugs" and the problem is growing, a coroner has said.
Nadine Smith died of a heroin overdose
Michael Moyle made his comments as he recorded a verdict of accidental death on 17-year-old Nadine Smith, who died of a heroin overdose in December 2005.
Nadine was living in a care home at the time and the Department of Health and Social Security (DHSS) said "lessons would be learnt".
The DHSS is examining a review into the circumstances surrounding her death.
An inquest into the death of Miss Smith, originally from Armagh, Northern Ireland, was held in Douglas on Monday.
The court heard that she had been in living in a care home in Onchan run by Manx Family Services, an organisation contracted to provide residential care for youngsters.
Miss Smith had admitted using drugs about two months before she died but attempts to get her a place in a UK rehabilitation unit were unsuccessful because she was still a minor, care workers said.
Describing her death as "a tragic waste of a life", Mr Moyle said anyone who did not see the drugs problem on the island was "living in a dream world".
A multi-agency review was launched after Miss Smith's death, and the DHSS and other agencies are currently considering its recommendations.
A spokesman said: "Work with young people affected by drugs and alcohol is an increasingly difficult area and Nadine's situation highlighted the need for more accessible treatment facilities for young people.
"However, lessons can still be learned from the circumstances surrounding Nadine's death and evidence relating to progress made in relation to the recommendations of the independent review was presented to the inquest."