A qualitative study of drivers of psychoactive substance use among Mekelle University students, Northern Ethiopia

Abstract

Background Psychoactive substance (PS) use is a public health concern among University students. Understanding the factors underlay the use helps to underpin effective preventive interventions. However, there is dearth of exploratory studies on the drivers of psychoactive substance use in Ethiopian universities. Here, we aimed to explore the drivers for psychoactive substance use among Mekelle University undergraduate students. Methods Exploratory qualitative study was conducted from April 1 to May 30, 2017. We conducted five focus group discussions (FGDs) and eleven in-depth interviews (IDIs) with students, proctors and bar owners. We also conducted three round interviews within two weeks interval with each of four key-informant researchers (KIR). Participants were selected purposively and the investigators conducted the discussions and the interviews using semi-structured guides. Data were audio-recorded, transcribed verbatim and imported into qualitative data analysis software for coding and analysis. An inductive approach was applied to crystalize non-repetitive emerging themes overarching the drivers for psychoactive substance use among university students. Results The following themes emerged as drivers for psychoactive substance use among University students; (1)feeling helpless following detachment from family, (2) prior experience with substances, (3) socialization reasons, (4) low academic performance, (5) physical environment (explained by easy access to substance and limited recreational alternatives), and (6) sub-optimal organizational support. Conclusions Multiple drivers that range from individual to structural levels are involved in university student’s use of psychoactive substances, with socialization process at the center of the factors. Thus, the study appeals for a range of multifaceted interventions directed to the individual, interpersonal and organizational level factors. Electronic supplementary material The online version of this article (10.1186/s13011-018-0190-1) contains supplementary material, which is available to authorized users.

Prevalence of, Factors Associated with and Level of Dependence of Psychoactive Substance Use among Mekelle University Students, Ethiopia

“…A qualitative part of the same project also shows that feeling helpless following detachment from family, prior experience with substances, socialization reasons, low academic performance, physical environment (explained by easy access to substance and limited recreational alternatives) and sub-optimal organizational support [22]. The high prevalence of psychoactive substance use, an array of the factors from the qualitative and quantitate factors and the high dependency rate on the substance implies the need to avail a continuum of early prevention strategies from high school to universities.…”

“…A recent population-based study among adolescents also shows that the perceived availability of drugs, a family history of use and peer pressure are positively correlated with substance use [21]. A previous qualitative study from Mekelle University also reveals that a range of individual, interpersonal (relational) and organizational factors drive university students toward psychoactive substance use [22]. However, there is a paucity of evidence regarding its prevalence and level of dependency in this vulnerable segment of the population in Ethiopia.…”

Socio-ecological influences of adolescence marijuana use initiation: Qualitative evidence from two illicit marijuana-growing communities in South Africa

“…Also, in Ethiopia, students cited poor socialisation skill as their reason for indulging in substance use as they wanted to gain the courage to carry out their thoughts. 38 Thus, when a person feels overwhelmed or incapable of performing an activity, they tend to look for a source of encouragement and may resort to substance use, either on their own volition or upon advice from their peers. 39 Hence, parents and guardians should have frequent conversations with their children to know their weaknesses and help them address such weaknesses so that they do not resort to illicit substances as a way to address such a weakness.…”

“…Thus, in contexts where marijuana is easily accessible, adolescents are bound to use it, as was the case in Ethiopia. 38 Neighbourhood characteristics have social influence on the development of a child. 59 Hence, children who grow up in unsafe neighbourhoods, such as where drugs are easily available or where people are seen to be openly indulged in drug abuse, end up copying such behaviour.…”

The use of new psychoactive substances (NPS) in young people and their role in mental health care: a systematic review

“…Overall, users are typically attracted by NPS due to curiosity and diffusion of social media users' experiences; easy availability/affordability from online drug shops; legality; intense psychoactive effects and likely lack of detection in routine drug screenings [6,[9][10]. Interestingly, drivers for NPS use among students from a University in Northern Ethiopia appeared to be not only the easy access to NPS and prior experiences with substances, but also interpersonal factors, including detachment from family and difficulties in socialization; environmental factors such as limited recreational alternatives; and a low academic performance [11]. Due to the rapid life cycle of these substances, current health professionals' NPS technical understanding is a reason of concern.…”