Volume 9 Number 1, 2024 Faculty of Social Sciences, Enugu State University of Science And Technology EDITOR-IN-CHIEF Prof. Oby Omeje MANAGING EDITOR Prof. Barnabas Nwankwo PUBLISHED BY ENUGU STATE UNIVERSITY OF SCIENCE & TECHNOLOGY JOURNAL OF SOCIAL SCIENCES & HUMANITIES 97 Awareness and Perception of Undergraduate Students on Hazards Associated with Substance Abuse among Students Onyenekwe, Ogochukwu Nneka Health Communication Unit, Department of Mass communication, Nnamdi Azikiwe University, Awka. on.onyenekwe@unizik.edu.ng Onyenekwe, Chinedum Charles Clinical Chemistry Unit, Department of Medical Laboratory Science, Nnamdi Azikiwe University, Awka. Abstract Substance abuse is on the rise among youths in Nigeria. An effective way of managing substance abuse is by advocacy and publicity. These can be achieved in sundry ways. Therefore the present study was designed to collect data on the awareness and perception of university students on the hazards of substance abuse. A well-structured questionnaire containing the indices for substance abuse advocacy and publicity was developed and uploaded online amongst Nnamdi Azikiwe University Students social media platforms. The members of the platforms were encouraged to participate in the online survey. The online submission platform was preferred since the instrument for data collection was also meant as an advocacy and publicity agent. The online submission also guaranteed the confidentiality of the participants. The study was conducted between May 2023 and August 2023. A total of 108 participants responded to the questionnaire. The data were expressed in frequencies while chi-square and likelihood ratio were used to evaluate data for interpretations. Significant value was place at p<0.05. The 4 most predominant substances abused were Indian hemp (29.6%), Methamphetamine (25.9%), Cocaine (15.7%) and Marijuana (11.1%) and the 3 most predominant impact of substance abuse were increased craving (45.4%), untidy appearance (19.4%) and emotional imbalance (11.1%), (X2= 53.500; P<0.001 & X2=129.037; P<0.001)respectively. The perception that substance abuse is associated with infection (73.1%) was high (X2=80.991; p<0.001) but the awareness of Rehabilitation centres (30.6%) for substance abuse victims was poor (X2=13.885; p<0.001). Crosstab analysis showed both perception of infections and awareness of rehabilitation centres (X2=6.530; p=0.038; Likelihood ratio= 7.438; p=0.024). About 95% of the participants proffered the development of a curriculum for advocacy and publicity of substance abuse as panacea in stemming the problem. It was observed that University students are aware of the menace of substance abuse but are not aware of existing rehabilitation centres for victims of substance abuse. It is the opinion of the authors that a well-developed curriculum is necessary for advocacy and publicity. Keywords: Advocacy, Publicity, Substance Abuse, University Students, Wellbeing Introduction Drugs are chemicals or substances that are administered in certain dosage and carries out its effect by altering some biochemical processes in the body. The altered biochemical process could be beneficial or detrimental on the body depending on the purpose of usage of the drug mailto:on.onyenekwe@unizik.edu.ng 98 or chemical. When taken, usually by swallowing, inhaling or injecting, abused substances find their way into the bloodstream. From the bloodstream, there move to the brain and other parts of the body. Pepple & Diri (2021) assert that in the brain, such substances may intensify or dull the senses, change how alert or sleepy people feel and might sometimes decrease physical pain. Because of the way these substances work on the brain, they affect the ability to make healthy choices and decisions. Drinking can make people more likely to get involved in dangerous situations like driving under the influence or engaging in unprotected sex. Drug administration is preferred when prescribed by individuals trained and knowledgeable in the act of dispensing drugs. The margin of safety in usage of prescribed drugs is slim and is found in dosage and half-life of the drug. Moreover drugs are prescribed for a purpose and should not be taken indiscriminately. There are some drugs classified as performance enhancers which it has been observed that youths have strong cravings for. These drugs are often prohibited because of their ability to overrule the normal thinking of the mind (Pepple & Diri, 2021). However, the classification suggests that youths might have been drawn to the usage of such drugs probably to enhance their performance in a particular activity. The usage has been observed among athletes for competitive purposes, amongst youths desiring prolonged sexual ecstasy, to subdue impact of stressors which could be physical, medical, emotional or environmental. The fact is that rather than open up for emotional support when passing through certain issues, such individuals with limited knowledge of the adverse effect of these performance enhancing drugs, engage in self-prescription or prescription by fellow users. They are only armed with the benefit of what they are about to achieve without knowledge of the consequences of what they are about to be entangled with. Because of the addictive nature of these performance enhancing drugs, youths engaged in indiscriminate usage present with biochemical addiction. Once this is attained, they are no longer in control of usage but under the biochemical impulses for increasing need of such substances. This biochemical addiction entails increase in dosage with time in order to achieve satisfaction. If help does not come at this point, such individuals living on substance abuse will head towards significant consequences which may result in morbidity or end up in fatality (Kobiowu, 2006). In recent times, the trend of substance abuse among youths is on the increase due to local availability of these recreational drugs like cocaine, codeine, mkpuru mmiri(crystal meth), Indian hemp, marijuana and testosterone. The usage among the youths might explain the sudden surge in unruly behaviours, unkempt appearance, increased involvement in violent acts, increase in cases of mental disorders and sudden deaths (Nsimba, 2010; Nasiru, Lydia, Alexander & Maru, 2019). The availability of substance abuse rehabilitation centres is scanty in Anambra state and in Nigeria. The cost of rehabilitation is even far beyond the reach of such youths and their families. All these are pointers for effective advocacy and publicity on substance abuse. This is with the belief that if enlightenment is achieved, it may satisfy the restlessness associated with youthful energies and help them to channel this restlessness productively. This study was designed as part of advocacy and publicity among university students by ascertaining their awareness and perception on the rampancy of substance abuse among the youths and its adverse effects. A well-structured questionnaire containing the indices of substance abuse can be used as a subtle instrument of advocacy and publicity among targeted 99 groups. Such a questionnaire despite consisting of questions/comments can be used as a double edge to interview and to expose the dangers of substance abuse to the targeted groups. Theoretical framework Many theories help to explain why individuals use and abuse substances. These include the moral, biological, psychological and social theories with interplays of them. While the moral model suggests that using a substance is a moral failing which will lead to a path of destruction, the biological theory helps us understand how substances impact our brain and the changes that happen. It posits that since every person and brain is different, we must look at biology as one potential factor in a substance use disorder (Crouse, 2018). On its part, psychological theory helps in understanding the behaviours that are happening while a person is under the influence of a substance. Subsumed in this theory are the learning theory, classical and operant conditioning. Social theories suggest that we learn from many areas around us-individuals, family, peers and from the community (Connel, Gilreath, Aklin & Brex, 2010). The social learning theory will be undergirding the present study. Social learning theory suggests that behaviour is influenced by the interaction of personal, social and environmental factors including intrapersonal factors, interpersonal factors, institutional or organisational factors, community factors and public policy (McLeroy, Bibeau, Steckler & Glanz, 1988). This theory promotes intersectionality. The social factors that influence individuals are complex. Such complexity will involve focusing on not only on the individuals in question but also on environmental and societal factors that such individuals are embedded in. Sociological theories acknowledge the importance of environmental factors for an understanding of substance use, abuse and problems (Clayton & Scott, 2021) Methodology An online questionnaire was designed and sent to the platforms of university students for them to participate in the advocacy and publicity of substance abuse. The purpose of the advocacy and publicity was explained to each of the students’ platforms. The social media platforms which the students use for communication were used to invite the students to participate in the advocacy and publicity. The online questionnaire was uploaded in May 2023 and responses from participants were harvested till the end of August 2023. A total of 108 university students participated in the advocacy and publicity of substance abuse. The participants that gave informed consent were the ones that responded to the questionnaire online. The sections of the questionnaire includes responses to questions such as; the most common substance abused among youths in Nigeria, ability to identify signs associated with substance abuse, hazards of substance abuse, susceptibility to infection, ability to distinguish their effect on communicable and non-communicable diseases and their awareness of any existing rehabilitation centres in Nigeria. These questions were used to assess and document their awareness and perception of consequences of substance abuse among the youth in Nigeria. The University Students were used for the study because of the proximity of space they share in campuses with individuals under the influence of substance abuse. Often they are the first to alert the University authority about cases of morbidity or mortality of classmates. It is therefore certain that they have knowledgeable exposure to respond to the questionnaire. 100 Findings The most common substance abused by youths in Anambra state was Indian hemp (29.6%), followed by Methamphetamine (25.9%), Cocaine (15.7%) and Marijuana (11.1%). Others like Codeine (6.5%), Testosterone (6.5%) and Nicotine (0.9%) were less commonly used. (Chi- square =53.500; P<0.001). Table 1. According to the survey reported in Table 2, the most significant impact of substance abuse on emotions/health was increased craving for substance abuse (45.4%), followed by un- kept/untidy appearance (19.4%) then emotional imbalance (11.1%). Others were weight loss (8.3%), unaware of environment (5.6%), eating disorder (3.7%), loss of consciousness (2.8%) and loss of financial acumen (2.8%). Craving for substance abuse and untidiness were significantly associated with substance abuse (chi-square=129.037; P<0.001). In Table, 3 about 73.1% of the participants’ perception was that substance abuse was associated with infection (Chi-square = 80.991; p<0.001) while only about 30.6% of the participants knew that Rehabilitation centres exist for individuals under the influence of substance abuse (Chi- square=13.885; P<0.001). These were a significant number. As reported in table 4, there was a negative insignificant association between awareness that substance abuse predisposes to infection and existence of rehabilitation centres (r=-0.098; p=0.331). As reported in table 5, the participants were better aware that substance abuse predisposes to infection than the availability of rehabilitation centres for individuals under the influence of substance abuse (chi-square=6.530; p=0.038; Likelihood ratio= 7.438; p=0.024). In table 6, about 95.4% of the participants think developing a curriculum for substance abuse advocacy and publicity is necessary (chi-square=97.152; p<0.001). Table 1: Most commonly used substances abused among youths in Anambra State Substance Frequency Percentage Chi- square p-value Indian hemp 32 29.6% 53.500 P<0.001 Methamphetamine (Mkpuru mmiri) 28 25.9% Cocaine 17 15.7% Marijuana 12 11.1% Codeine 7 6.5% Testosterone 7 6.5% Nicotine 1 0.9% Table 2: Emotional and health effects of substance abuse on youths in Anambra State Emotional/health effects Frequency Percentage Chi-square P-value Unkempt/untidy appearance 21 19.4% 129.037 <0.001 Loss of consciousness 3 2.8% Unaware of environment 6 5.6% Eating disorder 4 3.7% Craving for substance 49 45.4% Emotional imbalance 12 11.1% Loss of financial acumen 3 2.8% Weight loss 9 8.3% 101 Table 3: Perception and awareness of participants regarding association between substance abuse, susceptibility to infection and Rehabilitation Centres Table 4: Level of correlation between awareness that substance abuse predisposes to infection and existence of rehabilitation centres Parameters N Correlation coefficient (r) P-value Awareness of infection among substance abusers vs Awareness that Rehabilitation centres exist 104 -0.098 0.331 Table 5: Evaluating the Co-awareness of infection and Rehabilitation centres among participants. Table 6: Perception of participants on need to develop curriculum for substance abuse advocacy and publicity Category Yes (%) No (%) Not sure (%) Chi- square P- value Perception of infection among individuals on substance abuse 79 73.1% 20 18.5% 8 7.4% 80.991 <0.001 Awareness of rehabilitation Centres 33 30.6% 71 65.7% 4 3.7% 13.885 <0.001 Awareness of Rehabilitation Centres Tota l Statistic Yes No Pearson Chi- square (6.530; P=0.038) Likelihood ratio (7.438; P=0.024 Awareness of infection associated with substance abuse Yes 30 48 78 No 2 16 18 Not sure 1 7 8 Total 33 71 104 Category Yes Percentag e N o Percentag e Chi- square p-value Need to develop curriculum for substance abuse advocacy and publicity 103 95.4% 2 1.9% 97.152 <0.001 102 Discussion This study was intended to promote advocacy and publicity for substance abuse among Nnamdi Azikiwe University Students. An online questionnaire was administered with the view of accessing the awareness and perception of University students on substance abuse. The responses of the participating students to the questionnaire were an indication that substance abuse actually is a developing menace or beast among students of Tertiary education in Anambra State and Nigeria. The four most predominant substances abused among University students were Indian Hemp, Methamphetamine (Mkpuru Mmiri), Cocaine and Marijuana in decreasing order of abuse. These substances seem affordable and within reach of students may be due to local availability. Studies elsewhere have also identified the following recreational drugs as most rampant among youths. These include marijuana (WHO, 2004), regarded as the most widely used illicit substance globally (Shaul, Bernard, Kwame, Tony & George, 2013). Alchohol, tobacco and marijuana were predominant in (Pepple & Diri, 2021).Umukoro, Eduviere, Ahama, Moke, Edje, Omorodion and Ovigue (2021) in their study observed that alcohol was the most frequently abused drug. This finding was echoed by Awosusi & Adegboyega (2013) who also found that respondents who were students of tertiary institutions in South West Nigeria, claimed to have used alcohol (49.2%), cigarettes (26.9%) and marijuana (14.8%). It could not be said that individuals who live on recreational drugs do not know the consequences of such a life style. In the present study, predominant proportions of the participants about 1 out of every 4 participant, knew that individuals under the influence of substance abuse are susceptible to contracting infection due to some life practices associated with mental instability often exhibited by such individuals. For instance, it is well known that some of the ways of administering these recreational drugs could be by sniffing, ingestion, intravenous or intramuscular modes of administration. Now the risk of infection is found commonly among those that exchange sharp objects and unprotected sexual acts (Pepple & Diri, 2021) vis-à-vis multiple sexual partners particularly when under the addictive influence of the recreational drugs. Nwosu, Okeke, Rinmak and Onyenekwe (2023) identified such practices as smoking lizard parts and dung, sniffing glue, petrol, sewage and urine all in the name of ‘becoming high’. They continue that recently, these young men have turned to methamphetamine, a highly destructive drug also known as ‘mkpurummiri’ in local parlance. This study also showed that the three most predominant emotional or health effects or expression by these individuals under the influence of substance abuse were increased craving for the recreational drug which is due to biochemical addiction. This explains why the dosage is increased with the interval shortening over time to attain same effect. The other effects are untidiness and emotional imbalance. Untidiness can also predispose abusers to infections and ill health and might be mistaken for one of the agents of social ills or disturbance in the community. The emotional imbalance will surely predispose victims to poor judgement and reduced social tolerance that may result in violence and fright. Some reports have come up with similar vices associated with substance abuse among youths (Oshikoya & Alli, 2006; Awosusi & Adegboyega, 2013; Nasiru et al, 2019). Their findings also suggest that exposure to some of these recreational drugs are not in the best interest of the youth. They have also advocated for teaching the youths on how to manage stressors which have been implicated as triggers for search for comfort from recreational drugs. 103 The advocacy and publicity for substance abuse amongst the youths in Anambra State in particular and Nigeria in general seem poor. This is because knowledge or awareness of the problems associated with substance abuse without awareness of where and how to seek help for the affected individuals is a predicament. This study observed that a predominant number of the participants were aware of the consequences of substance abuse among the youths in Anambra state and Nigeria but very few knew about rehabilitation centres for victims of substance abuse. This might explain why in most cases, victims don’t seek help from the centres because neither the victims nor their relations are aware that such rehabilitation centres exist. In cases where they know such centres exist, their per capital income may be inadequate to meet the financial obligation. This scenario presents an irony where access to recreational drugs is seamless and cheap but access to rehabilitation centres for victims of substance abuse is financially burdensome. Lack of awareness about the means of seeking help might not be unconnected with the stigma associated with substance use. A World Health Organization report concluded that out of all health disorders, substance use and process addiction disorders were the most stigmatized (Rundle, Cunningham & Hendershot, 2021). This portrays a perspective of the moral theory. Oshikoya & Alli, 2006, similarly, reported that only 21.2% of respondents would associate with drug addicts, even after rehabilitation, 46.8% would neither marry nor allow their family member to marry a drug addict while 37.3% would not employ a drug addict even after rehabilitation. Access to rehabilitation centres in low income countries has been highlighted as a major challenge for recovery of victims of substance abuse because rehabilitation is expensive and such centres are few and far between (drugmedics.com; rehabhc.co.uk). While drugmedics.com list eleven centres across Lagos, Abuja, Anambra, Port Harcourt, Kano and Cross River States, rehabhc.co.uk list 23 centres offering rehabilitation services across four platforms in Lagos, Abuja and Rivers States. These platforms are hospitals, luxury rehabilitation centres, outpatient centres and residential/inpatient centres. Rehabilitation of victims of substance abuse takes time, finances and patience which many may not be willing to invest in. A significant disparity in awareness of indices for advocacy and publicity of substance abuse was observed. That significant numbers of participants knew that substance abuse was associated with predisposition to infection did not translate to the awareness that rehabilitation centres exist. This may be a negative challenge in the advocacy and publicity of substance abuse since majority of the population may not refer for help at rehabilitation centres. This is an indication for continued advocacy and publicity. Significant numbers of the participants are suggestive that developing a curriculum on substance abuse is necessary for effective advocacy and publicity. This will enable all stakeholders to be on the same page regarding scope and content and have measurable indices for assessing desired outcome and measuring successes and further areas of emphasis. Conclusion This study observed that University students are aware of the menace of substance abuse but are not aware of existing rehabilitation centres for victims of substance abuse. It is the opinion of the authors that a well-developed curriculum for advocacy and publicity containing all the indices of the consequences of substance abuse and existing care available to victims should be prepared and all stakeholders engaged to fight this menace among the youth. 104 References Awosusi, A. & Adegboyega, J. (2013). Knowledge of Health Effects and Substance Use among Students of Tertiary Institutions in South-western, Nigeria. Journal of Education and Practice. 4(23) ISSN 2222-288X (Online) Clayton, M. & Scott, A. (2021). Drugs and Drug Policy: The Control of Consciousness Alteration. 3rd Edition. Sage Publications Inc. thousand Oaks, California. Connell, C., Gilreath, T., Aklin, W. & Brex, R. (2010). Social-ecological influences on patterns of substance use among non-metropolitan high school students. American Journal of Community Psychology. 45(1-2): 36-48. https://doi.org/10.1007/S10464-009-9289-xpara.5. Crouse, J. (2018). Exploring Substance Use in Canada. https://ecampusontario.pressbooks.pub/centennialdrugshealthaddictionsbehaviour/chapter/the ories-of-substance-use-addiction/#navigation https://rehabs.africa>nigeria Accessed on 8th March, 2024 https://rehabhc.co.uk/alcohol-and-drug-rehab-clinics-in-nigeria Accessed on 8th March, 2024 https://drugmedics.com Accessed on 8th March, 2024 McLeroy, K., Bibeau, D., Steckler, A. & Glanz, K. (1988). An ecological perspective on health promotion programmes. Health Education Quaterly. 15(4): 351-377. https://doi.org/10.1177%2F109019818801500401 Nasiru, B., Lydia, A., Alexander, A. & Maru, S. , (2019). The Perception of Youth on the Effects of Substance Abuse in Sokoto, Sokoto State, Nigeria. World Journal of Pharmaceutical and Medical Research. 5(9): 122-129. National Bureau of Statistics Website. Accessed on 8th March, 2024. Nwosu, C., Okeke, A., Rinmak, N. & Onyenekwe, O. (2023). Newspaper Coverage of Drug Abuse among Nigerian Youths: A Study of Vanguard and Daily Trust. Mass Media Review 5(1): 77-98. Nsimba, S. (2010). Methadone Maintenance Therapy as Evidence Based Drug Abuse Planning in Developed Countries: Can Developing Countries Afford and Learn from this Experience? East African Journal of Public Health. 7(1): 56-59. Oshikoya, K. & Alli, A. (2006). Perception of Drug Abuse Amongst Nigerian Undergraduates. World Journal of Medical Sciences. 1(2): 133-139 Pepple, I. & Diri, (2021). Brief Review of Causes and Effects of Substance Abuse on Young Adults: Focus on Bonny Island Residents. Journal of Drug Abuse 7(5): 36. https://ecampusontario.pressbooks.pub/centennialdrugshealthaddictionsbehaviour/chapter/theories-of-substance-use-addiction/#navigation https://ecampusontario.pressbooks.pub/centennialdrugshealthaddictionsbehaviour/chapter/theories-of-substance-use-addiction/#navigation https://rehabhc.co.uk/alcohol-and-drug-rehab-clinics-in-nigeria https://drugmedics.com/ 105 Rundle, S., Cunningham, J. & Hendershot, C. (2021). Implications of addiction diagnosis and addiction beliefs for public stigma: A cross-national experimental study. Drug and Alchohol Review. 40(5): 842-846. https:/doi.org/10.1111/dar.13244 Umukoro, E., Eduviere, A., Ahama, E., Moke, E., Edje, K., Omorodion, L. & Ovigue, C. (2021). Substance Abuse: Awareness and Attitude among Secondary School Students in Sapele, Nigeria. Journal of Applied Sciences and Environmental Management. 25(3): 347-351. https://www.ajol.info/index.php/jasem Page 7