DRUG ABUSE AMONG SECONDARY SCHOOL STUDENTS IN BENIN CITY, NIGERIA

A DISSERTATION SUBMITTED TO THE NATIONAL POSTGRADUATE MEDICAL COLLEGE OF NIGERIA IN PART FULFILLMENT OF THE REQUIREMENT FOR THE FELLOWSHIP OF THE COLLEGE IN THE FACULTY OF PSYCHIATRY

BY

EMONENA WILSON EDAFIADHE M.B. B.S. (Benin)

MAY 2005

1

DECLARATION

It is hereby declared that this work is original unless otherwise acknowledged. The work has not been presented in part or whole to any other college for a fellowship or Diploma nor has it been submitted elsewhere for publication.

Signed: Dr. E. W. Edafiadhe

2

CERTIFICATION

The study reported in this dissertation was performed by the candidate under my supervision. I also supervised the writing of the dissertation.

Signature: ……………………………………………………

Name of Supervisor: …………………………………………

Status of Supervisor:…………………………………………..

Date: ……………………………………..

DR A. N. OTAKPOR FMC (psych) , FWACP SUPERVISOR

3

DEDICATION

Deservedly dedicated to my wife Mrs. Onoriode Rose Edafiadhe – My support and confident.

4

TABLE OF CONTENTS

SECTION Page

Declaration ii

Certification iii

Dedication iv

Table of Contents v

Acknowledgement vii

Summary 1

CHAPTER ONE

Introduction 3

CHAPTER TWO

Literature Review 8

Definition of Drug 8

Use and Abuse of Drugs 8

Drug abuse and Secondary School Students 9

Prevalence in Accessible population 10

Review former works on student 12

Control Measures (Demand Reduction

& Supply Control) 13

Legislation Issues 14

Psychosocial correlate 14

5

CHAPTER THREE

Aims of the study 18

General objectives 18

Specific objectives 18

CHAPTER FOUR

Methodology 19

Study Area & Sample Size 19

Selection of Schools 20

Inclusion criteria 21

Exclusion criteria 21

Instrument 21

Procedure 22

Data Analysis 23

CHAPTER FIVE

Results 24

CHAPTER SIX

Discussion 43

Pattern and prevalence 43

Methodological strength and weakness 46

Gender and Drug abuse 47

Highlights of Psychosocial correlates 48

6

CHAPTER SEVEN

Conclusion 50

References 51

Appendix 1 60

Appendix (Questionnaire) 61

7

ACKNOWLEDGEMENT

I thank my Supervisors Dr Alex Otakpor, Head, Department of

Mental Health, University of Benin, Benin City, for his support and advice at every stage of this study and Dr R. O. Osahon, Chief

Consultant and former Medical Director, Psychiatric Hospital, Uselu,

Benin City. I also wish to thank Dr (Mrs.) O. F. Ihenyen, Chief

Consultant and Medical Director, Psychiatric Hospital, Uselu, Benin

City for her encouragement. I wish to acknowledge the support of Dr.

G. O. Eze, Consultant Special Grade, and Head, Clinical Services department for his contribution to this work and my training as a

Resident Doctor. I also wish to extend my gratitude to Drs O. C. Ikeji,

S. O. Olotu and S. O. Agbahowe for their contributions. My sincere gratitude also goes to Dr. O. J. Oshodi for his immense assistance and support. I also wished to thank Mr. Henry Adeyemi Ibazebo,

Assistant Commander General – Narcotics (Rtd), NDLEA for supply of materials and his kind advice.

This work was conducted at selected secondary schools in

Benin City. The study would not have been possible without the assistance of the Principals, Staffs and Students. I thank them for their kindness, friendliness and patience. I also thank Prof. Olufemi

Morakinyo of the department of Mental Health, Obafemi Awolowo

University, Ile-Ife, for his interest and encouragement. He came to my

8

rescue when my zeal was waning. He accepted to vet the final work for the college. Furthermore, I thank Dr. R. Agidee for bringing me into psychiatry. He has continued to renew my interest. I also wish to thank Dr. V. O. Awusi of Alpha Medical Centre, Benin City for his support. My gratitude also goes to Dr. J. D. Adeyemi of the department of Psychiatry LUTH for his contributions and corrections to the final works. May I also acknowledge the invaluable contribution of Dr. Udofia of the department of Psychiatry, University of Calabar for lending his advice at the time of crisis. I also wish to thank Mr. L.

M. Ugbewanko for the typesetting of this work and his assistance in data analysis.

Lastly, I thank my wife Mrs. Onoriode Rose Edafiadhe and my

Children, Ozomaro, Bekie, Samson, Ovie-David and Oke for their support and prayers for my effort at achieving my life goals.

9

SUMMARY

The literature on Drug Abuse among youths is reviewed. There is a general agreement amongst health policy researchers that drug abuse among adolescents is on the increase. Alcohol, tobacco,

Cannabis, and the use of inhalants especially organic solvents have been observed to feature prominently in the drug use scene in the country today.

This study was conducted to assess the use of a wide variety of psychoactive substances by secondary school students in Benin City.

A total of 750 Senior Secondary School students in nine schools selected to represent the different secondary schools in the three

Local Government Areas in Benin City were assessed to determine the pattern of drug abuse.

Participants were drawn from SS III students. The student drug use questionnaire by WHO was used for the study. The sample of students was made up of 53% male, and 93% were Christian. The age of respondents ranged from 14 – 23 years. The mean age was

17years with a standard deviation of 1.4years. The findings of this study showed that: the age at first use of psychoactive substances ranged between 11 and 13 years; the lifetime use of these substances ranged from 1.5% for tobacco and opiates to 32% for

10

alcohol. Furthermore, more males than females were likely to consume alcohol and cannabis.

Among male students were significantly more current users of only alcohol (x2=5.7 1df P <0.05) and lifetime users (x2=4.0 1df P

<0.05) whereas female students reported a more significant current user of stimulants (x2=8.8 1df P<0.05) and lifetime use of inhalants

(x2=7.8 1df P<0.05)

Fourteen percent of respondents gave acceptability and sociability as the reason for their first use of drug. Peer group influence serve as the highest source of introduction of drugs and alcohol to the students.

The proportion of literate fathers was 80 percent depicting that the study was carried out in an urban area.

The substances found most commonly used fall mainly outside the class of hard drugs. The majority of users are experimenters and occasional users. Substance use prevention and control programmes should take due note in the design and implementation

11

CHAPTER ONE

INTRODUCTION

There has been a general consensus that the abuse of alcohol and drugs in Africa and other developing countries has been on the increase amongst youths (Pela 1988; Odejide 1980; Awaritefe and

Ebie 1975). This has led to a corresponding increase in research in this area.

A drug is defined as a substance by its chemical nature, affects the structure or function of a living organism such that when ingested, inhaled, injected or absorbed interacts with the individual and affects his/her physical, psychological and social milieu (Dusek and Girdano

1989).

Novadomsky (1981), in a survey of drug experimentation and

social use among secondary school students in Benin City, found

alcohol to be the most commonly used drug. Alcohol use and abuse

is on the increase in Nigeria (Anumonye et al. 1977). Alcohol is used

traditionally as a means of strengthening the bonds of friendship and

kinship (Umunna 1977; Odejide & Olatawura 1977). In a rural study

in Benin district in Nigeria, Oshodin (1981) found that 71% of 300

secondary school students used alcohol, 18% of whom could be

classified as current users. Along with this rising trend in the level of

12

abuse of alcohol is also the use of other drugs (Asuni et al. 1994;

Adelekan et al. 1997; Federal Ministry of Health 1991).

Pela (1988) noted the increased involvement of females not

only for alcohol use but also hypno-sedatives. Abiodun et al (1994)

found that in many cases of drug abuse, about half of the students

got initiated into it while in primary school with the figure rising to

about three quarters of the affected study population by early

secondary school (Classes I-III) period.

Students, many of whom are still in their formative years and in

transition to adulthood face a period of experimental exploration and

curiosity (Pela 1986). They are particularly prone to the many

destructive effects of drug abuse both physical and psychological.

Reports of the prevalence of alcohol abuse/dependence from Euro-

American countries have shown a level of about 9.3% in the U. S. A. and 5.3% in the United Kingdom (Grant 1994; Ritson et al. 1993). As a result of lack of whole population studies in Nigeria, no definitive prevalence rate of alcohol dependence is available. However, a general population study in the middle belt of Nigeria showed a prevalence rate of 20.8% for daily consumption of alcohol (Obot

1990). Also, 40-80% of Nigerian undergraduates were found to use alcohol (Ihezue 1988; Adelekan et al. 1993). Ifabumuyi & Ahmed

(1984) had screened patients at Ahmadu Bello University Teaching

13

hospital, Kaduna for alcoholism and found 16% of them dependent on alcohol. Gureje et al (1992) reported a rate of 1.7% among patients attending a general hospital outpatient clinic using standardized questionnaires.

Hospital data have shown that many alcohol abusers/dependents suffer from a variety of complications such as drunkenness, delirium, dementia, liver pathologies, polyneuropathy, impotence, social problems such as loss of employment, marital disharmony and financial problems (Adelekan et al. 1997). Nigeria is the most populous black country in the world, with an estimated population of

120 million, 54% and 70% of this population respectively are youths, and live in the rural areas (Obot 1992). The problems that drug abuse poses to these largely agrarian rural dwellers are enormous and tend to threaten the survival of the patient and his family. Ritson et al

(1993) noted that alcohol abuse markedly reduces work efficiency and overall farm output leading to low productivity, in addition, breaking of the law and order sometimes result.

A recent World Health Organisation (WHO) publication (2004) on the Neurosciences of substance use and dependence summarizes recent findings in this field as follows: substances differ with respect to specific receptors in the brain that the influence, though there are also considerable commonalities. Substance dependence is a

14

disorder that involves the motivational system of the brain. All dependence causing activate the mesolimbic dopamine system involved in behaviour like eating, sex or gambling. Dependence produces substances differs from conventional reinforcers in that their stimulant effects on dopamine release in the nucleus accumbens are significantly greater than natural reinforces such as food.

Dependence producing substances brings about positive effects on individuals as in sensation seekers and reduction of stress as in those feeling bad and needing self treatment.

Drug and alcohol abuse have been found to cut across all social groups and starts at a relatively earlier age in Nigeria (Abiodun et al.

1994). The work of Abiodun et al (1994) has been found to be similar to a study of secondary school students in the United Kingdom where

“up to a quarter of 13 and 14 year olds claimed to have ‘downed’ at least five alcoholic drinks in a single binge session (Awake 2004).

The influences of industrialization, urbanization and increased exposure to Western lifestyles have been reported to contribute to changing pattern of drug abuse in Nigeria (Pela 1986; 1988; Oshodin

& Goyea 1983).

Furthermore, it is likely that contemporary rural urban drifts, shifts and breakdown in the protective effect of the extended family system, socio-economic and psychosocial factors as postulated by

15

Adamson & Sijuwola (2001) may have worsened the pattern of alcohol and drug abuse among youths in Nigeria. Also, it has been reported that an increasing number of students in the secondary schools and the universities present to the psychiatric clinics and hospitals with psychological problems following psychoactive substance use (Ogunremi & Okonofua 1977). Moreover, recent studies on the pattern of drug and alcohol use among secondary school students in Nigeria concentrated mainly on other areas of the country except the Midwestern area.

This study will attempt to provide information that will inform health care planners on the recent trend in drug abuse among secondary school students in the Midwestern area. Furthermore, the awareness of the foregoing by health care providers should serve to enhance their knowledge base and influence their capacities in planning, instituting adequate and appropriate health care management principles and practices.

16

CHAPTER TWO

LITERATURE REVIEW

DEFINITION

The concept of drug abuse refers to the problems or adverse consequences associated with non-medical drug use (Smart el at.

1980). Odejide (1980) defined psychoactive substance abuse as the use of a substance when not physiologically or pharmacologically necessary, when it is used in the face of legal prohibition, or when its use is socially unacceptable, and with the quantity consumed exceeding what is culturally acceptable. In the same vain, Adamson

(1991) further defined drug abuse as a state in which a drug is used in excess of what is medically prescribed or socially acceptable resulting in impairment of social or occupational functioning occurring with prescription and non-prescription drugs. So even amongst experts cited above subtle differences exist in their definition of the problem.

USE AND ABUSE OF DRUGS

The use of drug is denoted by the act of taking it into the body to prevent or cure a disease or disabling condition as in accepting the sick role and to exploit it (Blum et al, 1969). Drug abuse on the order hand is the taking of drugs to an extent that they cause social or medical harm (Dusek and Girdano, 1989). Fortuna (1983), in using 17

cocaine abuse as example talked about three stages as follows: the first stage produces the euphoria enhanced by a feeling of confidence by peer pressure and by illusions of power perpetuates early use. If a strong psychological drive motivates frequent and heavy use, the second state of cocaine dysphoria in which user experiences apathy, increased nervousness, insomnia and increase weight loss set in. this lead on to the third stage of psychosis like acute paranoid schizophrenia like disorder.

The drugs generally used and abused according to the 10th edition of the international classification of diseases (1CD-10) are tobacco, alcohol, cannabis, stimulants (amphetamines), sedatives, opiates-heroin, volatile solvents, hallucinogens-mescaline and cocaine (world Health Organization 1992).

DRUG ABUSE AND THE STUDENT

Among youths, drug abuse cut across social class, age and sex it commences at an early age of about 10 years (NDLEA 1991, 1992) with socially acceptable habit forming drugs as alcohol and cigarettes known as ‘gate way’ drugs. Many youths run the risk of becoming drug dependent as they graduate into the use of more potentially dangerous drugs such as cannabis, heroin and cocaine (WHO 1980)

The abuse of substances has been associated with widespread number of possible causes. Several studies have suggested that

18

genetic factors act in a non specific way to influence the predisposition of an individual to drug abuse with psychiatric sequelae

(Kendler et al. 1999; Torgersen 1986; Crowe et al. 1983).

Genetic predisposition to substance abuse may operate through two mechanisms. Firstly, through direct inheritance while indirectly through a more circuitous route of aggression, conduct disorder, and the dissocial personality which eventually culminates in substance abuse (Cadoret et al. 1992). The association of drug abuse with social maladjustment and personality disorder with poor emotional control has been well documented by Stenbacka et al (1993).

The abuse of substances may well represent adaptive measure to cope with difficulties (Cancrini 1994). There is a general consensus that drug and alcohol abuse has been on the increase (Pela 1988;

Odejide 1980). Some high risk groups that have been identified include students, artisans, soldiers and farmers. (Boroffka 1966;

Novadomsky 1982; Makanjuola 1986). Furthermore, students who are still in their formative years and in a period of experimental exploration and curiosity are particularly prone to the many disruptive, physical and psychosocial effects of drug abuse (Pela 1986). This is because drugs exert their major effect on the brain leading to sedation, stimulation or change of mood or behaviour (Ebie 1988).

Oshodin (1981) in a survey amongst 300 secondary school students

19

in Benin City found that 71% used alcohol. In Nigeria, alcohol is the commonest substance of abuse in use (Novadomsky 1981, Ihezue,

1988, NDLEA. 1991. Adelekan, 1992) and in fact not regarded as a drug of abuse by many of its users. Its consumption has been closely linked to ritualistic or social events (Adelekan and Stimson, 1997). An important finding is that traditional medicinal preparations form a significant source of alcohol consumption (Odejide,1979). The history of the various substances of use and abuse in Nigeria shows that the country has not been immune to the events occurring in the world as a global village (Odejide et al, 1987).

Cannabis which now is grows wildly, was alien to Nigeria but suspected to have been introduced into the country by the sea boy and further spread by the soldiers who returned from the Second

World War (Oshodi, 1973, Boroffka, 1966). The presence of favourable climatic condition for its growth among other factors was further ensured its continued florid existence and abuse (Asuni,

1964). Cannabis is easily available and it is often used in combination with other substance such as cigarettes and alcohol (Lambo, 1965).

A sizeable number of drug abusers, particularly those involved in cannabis abuse have been described as drifters who are no longer within the control of the cohesive Nigeria family system (Asuni, 1954).

Odejide and Ohaeri (1989), in a review of substance abuse related

20

admissions in 28 mental hospitals in Nigeria over a one-year period found that cannabis was responsible for 63.5 percent and 52.6 percent of such cases in the North and South respectively. Surveys on the extent of use of cannabis generally may not reflect the true level of its abuse as a result of denial because of its illicit status and the attendant stigmatization (Asuni, 1964, Odejide, 1976,

Novadomsky, 1981). Increasing involvement of the female in drug use has however been reported (Adelekan and Adeniran, 1988; Ekpo et al, 1995). Anumonye, 1980, did not find any sex difference in the abuse of cannabis in his study of substance abuse among the yound people in Lagos. Various forms of psychiatric presentations have been described in the association with the use of cannabis including paranoid schizophrenia-like disturbances, acutely disturbed behaviour with perplexity, depressive and manic states, increased neurotic complaints and amotivational states. Furthermore, there are associated psycho-social problems like loss of job, infringement against the law, interpersonal relationship difficulties, disorder of behaviour and character which may result in gradual deterioration of the personality of the individual (Lambo, 1965; Annumonye, 1980,,

Oviasu, 1976). The Nigeria political and socio-economic fortunes has at various times further shapen the emerging pattern of substance use and abuse in the country (Novadomsky, 1981, Odejide et al,

21

1987, Odejide, 1989). The use of opiate was initially restricted to hospital staff who had access to them (Lambo, 1965). There are indications that more users have been recruited as Nigeria became more entangled with the international drug trade (Asuni and Pela,

1980, Adelekan and Adeniran, 1988, Ebie and Ebie, 1988).

The use of stimulants which was initially confined to the mild, locally available ones like kolanuts (caffeine containing) has over the years witnessed the introduction of drugs like the amphetamines, caffeine concentrates an the highly potent cocaine coming into the scene most recently (Oshodi, 1973; Ebie and Ebie, 1988; Adelekan and Adeniran, 1988). The amphetamines are illegally imported into

Africa (Ebie, 1982). Their use is a problem commonly found amound adolescents especially students, unskilled labourers and farmers

(Oshodi, 1973; Asuni and Pela, 1980; Ebie, 1982). Students use stimulants to keep awake during intense studying (Lambo, 1965;

Novadomsky, 1981; Adelekan et al 1992), the labourers use them to fight fatigue while the formers mostly in Northern Nigeria use them both to fight fatigue and to suppress appetite during famine. Oshodi,

1993 in his study of substance related problems in Kaduna over three years period noted that the abuse of amphetamine had assumed an epidermic proportion in the north particularly among soldiers, formers, labourers and students (Oshodi, 1973).

22

Another class of the commonly used drugs in Nigeria are the hypnosedatives, it has been shown to be in widespread use second only to alcohol in some studies (Novadomsky, 1981; Asuni and Pela,

1980; Ebie, 1982). Adelekan and Ndom, 1996 found 25 percent non- prescription life time use and 12.5 percent current use among secondary school students. The corresponding figures among the undergraduates’ samples were 36 percent and 22 percent respectively. The hypnosedatives commonly found in Nigeria include the benzo diazepine such as diazepam and nigrazepam and the barbiturates and barbiturates containing compounds such as butabarbitone, mandrax (Mixture containing methaqualone and diphenylhydramine. Chinese capsules containing short acting barbiturates and the stimulants, amphetamines). Some of the factors that have been implicated in the wide spread availability and use of hypnosedatives in Nigeria include poor prescription habits by Medical

Doctors, ability of non-medical professionals to prescribe them and poor legal control of its availability (Awaritefe and Ebie, 1975;

Akindele and Odejide, 1978; Odejide 1982; NDLEA, 1991; 1992).

Akindele and Odejide, 1978 found that 67 percent of the users in the community they studied obtained hyponsedatives without doctor’s prescription. There are suggestions that the use of hypnosedatives

23

may be more rampant among the females (Novadomsky, 1981; Ebie,

1981; Odejide, 1982; NDLEA, 1991, 1992).

The latest drugs in the substance abuse scene in Ngiera are the

‘hard drugs’ which often refers to cocaine and heroin. These are merging reports of an increased in use of these substances particularly in the cities (Adelekan and Adeniran, 1988; NDLEA, 1991,

UNDCP, 1991). The figures for the use of these drugs may be at par with those of traditional drugs like cannabis (UNDP, 1991). There is some regional variation in their use with a more widespread use in the south than in the north especially Lagos area (UNDCP, 1991).

The information on “Area boys” in Lagos is quite illuminating in this regard (Ekpo et al, 1995). The increased use of these drugs is thought to be sequelae of the increased surveillance in their trafficking resulting in the local use of what is meant for international consumption )ICAA, 1988, NDLEA, 1991, 1992; Ohaeri and Odejide,

1991). Those who abuse heroin and cocaine are more likely to be poly substance abusers and they run the risk of medical, social and psychiatric complications (Adelekan and Adeniran, 1988; Adamson,

1991). As a result, there is upsurge in the number of cases admitted in relation to the use of these drugs (NDLEA, 1991, 1992). The abusers are often males who are single, unemployed, semi skilled or unskilled with history of educational difficulties (Adelekan, 1988). The

24

females are becoming more involved just as children are no longer immune to them (NDLEA, 1991, 1992).

PREVALENCE OF PSYCHIATRIC MORBIDITY WITH DRUG

ABUSE

Individual personality (nature or character of a person) determines vulnerability to developing mental illness (Gelder et al,

2001). A combination of psychological characteristics, which include concepts like lifestyles, attitudes, skills, beliefs, affective responses, aggressiveness, intelligence etc are exhibited in a wide range of social and personal context and it is a difficult variable to control as regards mental illness (Tyrer 1988). Jegede (1980) in his survey of

970 students of the university of Ibadan, found a prevalence rate of psychiatric morbidity and drug use problems similar to the findings of

Segal (1966) who reported a prevalence rate of 7– 16% in a review of five universities studies in 1966.

In a study by Okulate & Osibogun (2001) they reported the following Psychiatric disorders including alcohol/substance use problem prevalence rates in 2394 individuals who had experienced symptoms within four weeks prior to the onset of their study. These rates include; alcohol abuse/dependence, 18%, other anxiety and depressive disorders, 19.8%.

25

Several studies have quoted different prevalence rates for drug abuse in Nigeria. Ogunremi & Okonofua’s (1977) study of university undergraduates found a prevalence rate of 26 percent while Anochie et al (1997) found overall lifetime and current use prevalence rates of drug abuse of 50.7% and 19.5% respectively. Odejide (1980) in a review of literature on drug abuse in Nigeria reported that youths of different socio-economic backgrounds indulge in the abuse of stimulants and psychedelic drugs. Also, several authors have reported on the pattern of drug use in Nigeria among youths. For example, Akindele (1974) reported that Indian hemp or cannabis and stimulants such as amphetamines and its derivatives were among the commonly abused drugs in Nigeria. Also, Olatawura (1974) reported on some aspects of the problem of Nigerian privileged youths.

Furthermore, he stressed their abuse of drugs such as cannabis and amphetamine.

Some of the reasons identified by Akindele and Odejide (1978) that make youths use drugs in their studies were, to keep awake at night, to feel at ease, to gain confidence in talking to superiors, to feel happy when unhappy and fed up, to facilitate enjoyment of social activities, and to induce sleep. Also, some of the sociological factors influencing drug use identified by them were the consequences of unhappy and poor background culminating in defective personality

26

development, the pressure to succeed in academic work, the influence of the significant other (peer groups, parents etc) and the ineffective control on the purchase and sale of addictive drugs.

REVIEW OF FORMER WORKS ON STUDENTS DRUG USE

In a recent study by Anochie et al (1997) in Port Harcourt metropolis, one thousand and twenty final year secondary school students (SSIII) were surveyed using a modified WHO self-reporting drug use questionnaire in May 1997. Males constituted 54.2% and females 45.8% of the study population. The mean age was 19 years.

The students had limited knowledge about drug abuse, its consequences and treatment. About 48% of the students demonstrated negative attitude towards drug abuse believing that it was harmful.

The overall lifetime and current prevalence rates of drug abuse were 50.1% and 19.5% respectively. The most currently abused drugs were found to include alcohol (12.5%), Cigarette (2.7%) and amphetamine (1.9%). The current use of alcohol and cigarette were significantly more common in males and no significant sex difference was noted for the other drugs surveyed. Age of initiation of some drugs was 10 years when children were in primary schools.

Oshodi, 1981, studied 300 secondary school students for drug abuse in Odighi village, 50 kilometres from Benin City. The findings

27

were 71 percent of the students use alcohol – lifetime use, 18 percent of who he classified as alcohol abusers. The students use and abuse of alcohol were for social and psychological reasons. Oshodi, 1981, in another study of secondary school students in Benin City found that

87 percent of the respondents drank alcohol and 21 percent indicated a pattern that was classified as alcohol abusers. The rural study enables comparison to be made with the urban situation. The findings showed that alcohol use is rampant in both rural and urban secondary schools and has been classified as a major offence and a contributor to the lack of discipline among students (Nwanam 1971; Onabamiro,

1977).

CONTROL MEASURES

In a review of literature on problems of drug abuse in Nigeria,

Odejide (1980) explained that primary prevention aims at educating the masses about the dangers inherent in drug abuse and also at controlling the availability of habit forming drugs. The mass media can be used to implement this goal. Also secondary prevention involves early treatment of identified cases and their reintegration with the society. Furthermore, tertiary prevention deals with the rehabilitation of treated cases. He noted the paucity of facilities either by government or non-governmental agencies involved in preventive measures.

28

Legislation to control Drug Abuse

The law in Nigeria forbids potent drugs being sold in patent medicine stores but it appears the law is not adequately enforced.

Information from research reports shows that habit forming drugs were indiscriminately sold in Nigeria (Akindele 1974; Odejide &

Sanda 1976). Many of these drugs are purchased from patent medicine stores and the street vendors, without prescriptions. The classified drugs – amphetamine and its derivatives can readily be purchased from chemists and even roadside hawkers without the doctor’s prescription. The Nigerian government promulgated the

NDLEA decree 48 (Federal Republic of Nigeria 1989) which forbids the sale by hawking of classified drugs or poison, in public places and prescribed stringent punishment for defaulters (Adelekan et al. 1992).

The National Drug Law Enforcement Agency (NDLEA) is charged with the supply, control and demand reduction. The supply or interdiction unit needs to gear up to prevent the planting of Indian hemp which is grown and widely used in Nigeria. The farms are usually situated in the thick forest and their discovery follows a tip-off by some members of the public (Awaritefe & Ebie 1975).

PSYCHOSOCIAL CORRELATES

In two cross-sectional studies carried out by Ndom & Adelekan

(1988, 1993) on the psychosocial correlates of substance use among

29

undergraduates in Ilorin, Nigeria. They used information on correlates of alcohol, cigarettes and cannabis use that were derived from the repeat cross-sectional surveys provided on substance use pattern.

This information was correlated with socio-demographic variables such as familiar and best friend’s usage and perceived harmfulness.

They found consistency in the significant correlations between the following;

(i) Lack of religiosity and the use of the three substances

(ii) Drinking and the presence of study difficulty, strained

relationship with teachers and belonging to the Christian

religion

(iii) Smoking and the male gender and self-reported poor mental

health;

(iv) Cannabis use and belonging to the older age group.

(v) Respondent use of the substances and use in the peer,

siblings, and parents in that order;

(vi) Perception of substance as harmful and low use rates

(vii) Perception of easy availability and high use rates.

The authors noted their limitation here that being a repeat cross-sectional study, the samples are not the same although drawn from the same sample frames. This increases the likelihood of the

30

presence of inter-sample confounding factors that may account for some of the differences observed.

Furthermore, Nigeria has undergone serious political and socioeconomic problems during the interval of the two phases of the study; consequently, the response provided on the psychosocial items in the questionnaire may be coloured by the prevailing situation in the country at the time of the survey.

Nevertheless, the use of a self reporting questionnaire method could not facilitate an in-depth discourse on items that emerged as significant correlates. A more general limitation to the cross-sectional design, perhaps, is the difficulty in establishing a cause and effect relationship on the findings though most of the psychosocial correlates of substance use were however replicated. For example lack of religiosity was significantly correlated with drinking, smoking and Cannabis use in both phases of the 1988 and 1993 studies. The significant influence of substance use behaviour of the respondents by the peer group represented by the best friend, sibling’s father and mother in that order in 1993 are consistent with the 1988 findings.

The author noted that there was over-representation of drinkers, and smokers among the respondents who reported below-average academic performance. They posited that it could be due to frustration leading from inability to cope academically that

31

encouraged sublimation into substance abuse. Conversely, the physical and mental effects of substance use and abuse could result in poor academic performance. Also smokers were significantly more likely, to come from homes where the parents were separated or divorced. It remains uncertain if the smoking behaviour have resulted from adjustment reaction to family disintegration or not. Higher lifetime cannabis use rate was found among respondents who reported that their fathers were dead, although age of respondents at the time of death was significantly pre-adolescent.

In Conclusion, the authors agreed that because of the difficulties in establishing a cause and effect relationship in the studies due to the study design using the repeat cross-sectional survey method, only plausible explanations could be advanced for some of the findings; they strongly identify the need for further qualitative studies which may facilitate a better understanding of the findings, and an appropriate weighting of their significance in packaging preventive interventions.

32

CHAPTER THREE

AIMS OF THE STUDY

3.1 GENERAL OBJECTIVE

To determine the pattern of Drug Abuse among secondary

school students in Benin City.

3.2 SPECIFIC OBJECTIVES

1. To determine the prevalence of drug abuse among

secondary school students in Benin City.

2. To highlight the psychosocial correlates associated with

drug abuse among secondary school students in Benin

City.

33

CHAPTER FOUR

METHODOLOGY

STUDY AREA

This study was conducted in May 2004, among secondary schools located in Benin City of Edo State. Benin City consists of Oredo, Egor and Ikpoba Okha Local government areas.

SAMPLE SIZE DETERMINATION

Sample size = p x q (SE)2

Where p = prevalence

q = 100 – p

SE = sampling error tolerated

The minimum sample size will be calculated using the formula above.

A recent study has shown that the current prevalence of drug abuse among adolescents in a Southern part of the country is 20%.

(Anochie et al, 1999).

If the prevalence of the condition to be studied is or more than 10% an estimated sampling error of 1.5% or more is acceptable.

(Minassian, 1997).

Therefore the minimum sample size

= 20 x (100 – 20) (1.5)

= 711

34

SAMPLE SELECTION

A multi-staged proportionate sampling technique was used to select nine schools from the 45 government secondary schools based on local government area and sex (coeducational – Males &

Females) into five coeducation, two female only and two males only.

The population of SSIII students in Benin City in the year 2004 is 9000 (Ministry of Education) in the total 45 schools. One hundred

SS III students were selected each from the nine schools, totaling 900 who are eligible.

The 45 secondary schools were distributed as follows: Oredo

15, Egor 13 and Ikpoba Okha 17. The schools were distributed into local government areas and further by sex; into Oredo (5 coeducational, 7 females and 3 males), Ikpoba Okha (8 coeducational and 4 females), Egor (11 coeducational and 2 males).

The total number of schools were 24 co-educational, 11

Females and 10 Males. A cohort of 2 all Male and 2 all Female and 5 coeducational schools was chosen, spread across the 3 Local government areas by simple random sampling of balloting from each section of the strata.

The details showing names of schools selected from each Local

Government Area are shown in Appendix 1.

35

INCLUSION CRITERIA

. The students must be in SSIII class

. The student must give informed consent to participate in the

study

EXCLUSION CRITERIA

. Student too ill to take part in the study

. Students not present in school during the period of study

. Those who did not consent to participate in the study

INSTRUMENT

The instrument used for the study was a drug-use questionnaire modified from World Health Organization (WHO) -Student Drug use questionnaire (Smart et al, 1980). The questionnaire has been tested and found valid for epidemiological surveys in Nigeria (Adelekan &

Odejide. 1989). A section of the questionnaire provides questions on socio-demographic data. The next section assessed current and lifetime use of drug and the attitude of the respondents towards drug abuse. “Lifetime” use was defined as ‘ever use’ of any of the listed drugs and Current use as the use of any drug(s) in the past 30 days.

The last question provided information on the students’ belief about drug abuse. Drugs included in the survey were tobacco, alcohol, cannabis, heroin, cocaine, inhalants, hallucinogens and amphetamines.

36

Pre-test of the questionnaire was carried out with about 100 students from another school not involved in the study. The questionnaires were reviewed and necessary adjustments made.

In each school, a minimum of 100 students, who gave informed consent, were selected by a systematic method of simple random technique of balloting.

PROCEDURE

The selected schools were visited to familiarize the investigator with the schools and inform the principals of the date of the study. In each school, all the SS III students were gathered into the school hall.

The author was then introduced to the students by the vice principal.

A detailed explanation was made on the nature and purpose of the study. The students were assured of anonymity and confidentiality, and their informed consent was obtained. In all, 150 respondents opted out of the study on their own volition. The questionnaires were distributed by the author. The teachers were neither allowed into the hall during the filling of the questionnaire, nor the respondents allowed to communicate with one another while the exercise was in progress. The author supervised the students and offered explanations to them when required while the session lasted between

37

45 to 60 minutes. The survey took five days. All fully completed questionnaires were submitted through collection in a centre container to further enhance anonymity and confidentiality. The raw data was collated into a master sheet and subsequently analysed.

DATA ANALYSIS

The Statistical Package for the Social Sciences version 11.0

(SPSS 11.0) (2001) was used to perform the descriptive statistics; these include measures of central tendency like Mean and Measures of Variability such as Standard Deviation, Range, and frequency distribution amongst the respondents. This was necessary for describing and understanding the variables. All other analyses considered necessary were also performed with aid of this package.

38

CHAPTER FIVE

RESULTS

5.1 Socio-demographic characteristics:

Table I below shows that nine hundred students were selected

for the study but a total of 150 opted out. Seven hundred and

fifty respondents participated in this study.

Age

The respondents ranged from 14 - 23 years with a mean of

17years and a standard deviation of 1.4. There were no

students within the ages of 20 to 22 years.

Gender

Three hundred and ninety-nine of the students were male which

accounted for 53 percent.

Religion

Seven hundred and two of the respondents were

Christians account for 94 percent.

The frequency distribution for the socio-demographic

characteristics is shown in Table 1.

The socio-economic status of the respondents was roughly

derived using the father’s educational attainment. From this,

37.5 percent could be classified into a high socio-economic

39

status, 30.5 percent medium and 32 percent low socio-

economic status.

Table 1: Socio-demographic characteristics of respondents

Characteristic N %

Sex

Male 399 (53.2%)

Female 351 (46.8%)

Total 750 (100%)

Age in school Male Female Total

14.00 19 (4.8%) 18(5.1%) 37(4.9%)

15.00 51 (12.8%) 33(9.4%) 84(11.2%)

16.00 54 (13.5%) 31(8.8%) 85(11.3%)

17.00 175(44.0%) 149(42.5%) 324(43.2%)

18.00 76(19.0%) 95(27.1%) 171(22.8%)

19.00 18(4.5%) 19(5.4%) 37(4.9%)

23.00 6(1.6%) 6(1.7%) 12(1.6%)

Mean age 17 Yrs

Religion

Islam 27 (6.8%) 21(5.9%) 48(6.4%)

Christian 372(93.2%) 330(94.1%) 702(93.6%)

40

PATTERN OF DRUG USE

The pattern and prevalence of most psychoactive substances and alcohol abuse shows that the latter has the highest percentage of

32.2%, followed by inhalants with 9.6%, amphetamine 8.0%, sedatives with 7.8%, and cannabis 6.4%. The overall lifetime and current use rates are 75% and 31% respectively for alcohol and other psychoactive substances as shown in Table 2. The majority of the

“current users” of the commonly used substances could be regarded as “occasional users” except for Tobacco where 1.5% reported daily use. Breakdown of abuse/non-abuse for each of the drugs are contained in Tables 3 to 7.

Prevalence of substance use

The most currently used drugs were alcohol, inhalants, stimulants, sedatives and cannabis in that order. The same trend was observed for lifetime use.

Among male students were significantly more current users of only alcohol (x2=5.7 1df P <0.05) and lifetime users (x2=4.0 1df P <0.05) whereas female students reported a more significant current user of stimulants (x2=8.8 1df P<0.05) and lifetime use of inhalants (x2=7.8

1df P<0.05)

41

Table 2

LIFE-TIME, 12 MONTHS AND 30 DAYS ABUSE OF VARIOUS DRUGS AND ALCOHOL BY STUDENTS OF SS III CLASS

12 DRUGS ABUSE LIFE-TIME MONTHS 30 DAYS (%) (%) (%) TOBACCO Yes 11 1.5 11 1.5 11 1.5 No 739 98.6 739 98.6 739 98.6 ALCOHOL Yes 241 32.2 180 24 96 12.8 No 509 67.9 570 76 654 87.2 CANNABIS Yes 48 6.4 24 3.2 12 1.6 No 702 93.6 726 96.8 738 98.4 COCAINE Yes 12 1.6 0 0 No 738 98.4 750 100 750 100 AMPHETAMINE Yes 60 8.0 49 6.5 25 3.4 No 690 92 701 93.5 725 96.6 HALLUCINOGEN Yes 12 1.6 0 0 No 738 98.4 750 100 750 100 INHALANTS Yes 72 9.6 25 3.4 46 6.5 No 678 90.4 725 96.7 704 93.5 TRANQUILIZERS Yes 13 1.8 12 1.6 0 No 737 98.3 738 98.4 750 100 SEDATIVES Yes 58 7.8 0 24 3.2 No 692 92.3 750 100 726 96.8 HEROIN Yes 36 4.8 11 1.5 13 1.8 No 714 95.2 739 98.6 737 98.3 TOTAL Yes 563 75.3 312 41.6 671 30.8

42

The prevalence of lifetime, Past year and past month tobacco taking is presented in table 3. Among the respondents’ lifetime, past year, and past month prevalence was 1.5% with the females marginally higher than males.

43

Table 3

TOBACCO (n = 750)

Male Female Frequency

Lifetime

Yes 4 (1.0%) 7 (1.9%) 11(1.5%)

No 395 (99.0%) 344(98.1%) 739(98.5%)

12 Months

Yes 4 (1.0%) 7(1.9%) 11(1.5%)

No 399(99.0%) 351(98.1%) 739(98.5%)

30 Days

Yes 4(1.0%) 7(1.9%) 11(1.5%)

No 395(99.0%) 344(98.1%) 739(98.5%)

44

The prevalence of lifetime, past year and past month alcohol respondents are presented in table 4. Among the respondents’ lifetime, past year and past month prevalence was 32.1%, 24% and

12.8% respectively and the sex distribution as well. n=750.

Among male students were significantly more current users of only alcohol (x2=5.7 1df P <0.05) and lifetime users (x2=4.0 1df P <0.05).

45

Table 4

ALCOHOL (n = 750)

Male Female Frequency

Lifetime

Yes 141(35.3%) 100(28.5%) 241(32.1%)

No 258(64.7%) 251(71.5%) 509(67.9%)

12 Months

Yes 96(24.0%) 84(24.0%) 180(24.0%)

No 303(76.0% 267(76.0%) 570(76.0%)

30 Days

Yes 62(15.5%) 34(9.7%) 96(12.8%)

No 337(84.5%) 317(90.3%) 654(87.2%)

46

The prevalence of lifetime, past year and past month cannabis respondents are presented in table 5. Among the respondents’ lifetime, past year and past month prevalence was 6.4%, 1.6% and

3.2% respectively as well as the sex distribution of the respondents. n=750.

Table 5:

CANNABIS (n = 750)

Male Female Frequency

Lifetime

Yes 25(6.3%) 23(6.5%) 48(6.4%)

No 374(93.7%) 328(93.5%) 702(93.6%)

12 Months

Yes 13(3.3%) 11(3.1%) 24(3.2%)

No 376(96.7%) 340(96.9%) 726(96.8%)

30 Days

Yes 6(1.5%) 6(1.7%) 12(1.6%)

No 393(98.5%) 345(98.3%) 738(98.4%)

47

The prevalence of lifetime, past year and past month Amphetamine respondents were presented in table 6. Among the respondents’ lifetime, past year and past month prevalence was 8.0%, 6.5% and

3.4% respectively. From table 6, it is indicated that females used amphetamines more than the male respondents. n= 750.

Females students reported more significant current user of stimulants

(x2=8.8 1df P<0.05).

Table 6

AMPHETAMINE (n = 750)

Male Female Frequency

Lifetime

Yes 22(5.5%) 38(10.8%) 60(8.0%)

No 377(94.5%) 313(89.2%) 690(92.0%)

12 Months

Yes 17(4.2%) 32(9.1%) 49(6.5%)

No 382(95.8%) 319(90.9%) 701(93.5%)

30 Days

Yes 6(1.5%) 19(5.4%) 25(3.3%)

No 393(98.5%) 332(94.6%) 725(96.7%)

48

The prevalence of lifetime, past year and past month Inhalant

(aerosol and glue) respondents was presented in table 7. Among the respondents’ lifetime, past year and past month prevalence was

9.6%, 3.3% and 6.5% respectively. Female preponderance is also indicated in lifetime use of inhalants (x2=7.8 1df P<0.05). n= 750.

Table 7

INHALATION AEROSOL & GLUE (n= 750)

Male Female Frequency

Lifetime

Yes 27(6.7%) 45(12.8%) 72(9.6%)

No 372(93.3%) 306(87.2%) 678(90.4%)

12 Months

Yes 15(3.9%) 10(3.0%) 25(3.3%)

No 384(96.1%) 341(97.0%) 725(96.7%)

30 Days

Yes 26(6.5%) 23(6.6%) 46(6.2%)

No 373(93.5%) 328(93.4%) 704(93.8%)

49

Age at first drug use;

As indicated in table 8, some drugs were initiated by the students before or at 10years of age. Inhalants were the commonest drug initiated at 10years by 1.6% of the respondents. Hallucinogens, cocaine, and sedatives were not started at an early age. Very few drugs, for example, cocaine were started after the age of 19years. n=750.

50

Table 8 Table 8 : Age at first attempt of Abuse of Drugs and Alcohol by SSIII Students

DRUGS <= 10yrs 11 - 12yrs 13 - 14yrs 15 - 16yrs 17 - 18yrs >=19 yrs Never

TOBACCO 0.00 0.00 11 0.00 0.00 0.00 739 (1.5%) 98.5% ALCOHOL 0.00 12 23 144 36 25 510 (1.6%) (3.1%) (19.2%) (4.8%) (3.3%) 68.0% CANNABIS 0.00 12 12 0.00 0.00 0.00 726 (1.6%) (1.6%) 96.9% COCAINE 0.00 0.00 0.00 0.00 0.00 12 727 (1.6%) 96.9% AMPHETAMINE 0.00 0.00 24 0.00 12 0.00 714 (3.2%) (1.6%) 95.2% HALLUCINOGEN 0.00 0.00 0.00 12 0.00 0.00 738 (1.6%) 98.4% INHALANTS 12 34 0.00 12 1.60 1.50 738 (1.6%) (4.5%) (1.6%) 98.5% TRANQUILIZERS 12 0.00 13 0.00 0.00 0.00 725 (1.6%) (1.8%) 96.5% SEDATIVES 0.00 0.00 11 0.00 0.00 0.00 739 (1.5%) 98.3% HEROIN 12 0.00 0.00 11 0.00 0.00 739 (1.6%) (1.5%) 98.3%

51

EDUCATION OF PARENTS

As indicated in Table 10, fathers’ had education from primary school to university while some mothers had no formal education. Thirty seven and half (37.5%) percent of the students had fathers with post secondary education while 30 percent had fathers with secondary education. The primary education of the parents showed that fathers had 12.5%. This shows a literacy rate of 80 percent, as the study was carried out in urban area.

52

Table 10

EDUCATION OF PARENTS (n = 750)

Father Percentage Mother Percentage

No formal education - - 36 4.8

Primary School 94 12.5 130 17.3

Secondary school 229 30.5 256 34.1

University 282 37.5 181 24

Don’t Know 145 19.3 147 19.5

TOTAL 750 100 750 100

53

Friends serve as the highest source of introduction of drugs and alcohol to the students though most others cannot readily pin point how they were introduced to drug and alcohol abuse as shown in the pie chart illustrated in figure 1.

54

SOURCE OF INTRODUCTION OF DRUG

Friends 309 41.20% Don’t Know 286 38.13% Dr. (Physician) 61 8.13% Other Health Practitioner 23 3.07% Drug Pusher 23 3.07% Others 25 3.33% Family 12 1.60% Casual Acquaintance 11 1.47% 750 100.00%

Fig. 1

55

Acceptability and sociability with peer group ranks highest as reason for their first use of drugs and alcohol as in pie chart in Figure 2.

56

REASON FOR THE FIRST USE OF DRUG

Religion 12 2% Acceptability & Sociability 108 14% Enjoyment 59 8% Enhance Sex 24 3% Curiosity 67 9% Treatment for health disorder 48 6% Relief of psychological disorder 48 6% Relief of fatique, cold & hunger 12 2% Improve work 25 3% Others 25 3% Don't know 322 43% 750 100%

Fig. 2 57

CHAPTER SIX

DISCUSSION

6.1 Pattern and Prevalence

Drugs Abuse

The problem of drug abuse among secondary school students was

examined. The notable findings were overall lifetime and current use

prevalence rates of 75 percent and 31 percent respectively. This is similar

to the findings of Adelekan et al (1977) of 77 percent overall lifetime and

42 percent current use. But the findings of Anochie et al (1999) in the study

of students in Port Harcourt were overall lifetime of 50.7 percent and 19.5

percent for current use showing that drug use may be lower in the oil city.

This may be due to extensive urbanization and westernization eroding

culture in Benin City as noted by Pela (1988).

Alcohol

Alcohol lifetime prevalence rate is 32.2 percent and it was the most

common drug abused by students in this study. This is high compared to

Anochie et al. (1999) finding of 12.5 percent and NDLEA (1992) of 1.6

percent in Kano State, where most of the students were Moslems as

against the largely Christian Southern students where alcohol is socially

acceptable. Also this may be due to ready availability and lack of restrictive

laws on alcohol use. Among male students were significantly more current

58

users of only alcohol (x2=5.7 1df P <0.05) and lifetime users (x2=4.0 1df P

<0.05). This is similar to the findings of Abiodun et al (1994). Lifetime use of alcohol increased significantly with decreasing age among the age groups examined in this study.

Amphetamine

Females students reported more significant current use of stimulants

(x2=8.8 1df P<0.05). This is in agreement with study done by Adelekan

(1989; 1992). Ogunremi and Okonofua (1997) reported a similar increase in prevalence of amphetamine abuse especially during final examination term, as amphetamines are taken by students to keep awake to study for examination. The desires for academic success to fulfill parental expectations have been suggested as some of the motivating factors for indulgence in stimulant use. It is also noted that students who engage in prolonged use of stimulants may present in hospital with complaint such as anxiety, restlessness, tremors, insomnia, headache and confusion, (Asuni

& Pela 1986).

Tobacco

Of the respondents, 1.5% admitted to smoking tobacco both lifetime and current use. This is rather low. It is interesting that females seem to use and abuse tobacco more than males in this study. It is also discouraging that current use engaged in daily use. The female preponderance is not in keeping with earlier reports. However, rapid

59

westernization as captured in foreign films where female smoke cigarettes, may be eroding our culture thus accounting for the gender shift in this study. It may therefore be necessary to assess the psychosocial correlates of tobacco use in the survey population in a further study.

Cannabis

The respondents reported a lifetime use of cannabis of 6.4 percent and a current use of 1.6 percent with a past year use of 3.2 percent. These figures are generally lower than those earlier reported from Nigeria and elsewhere in Africa (Ogunremi & Okonofua, 1977; Ihezue, 1988; Howart,

1982) and much lower than figures obtained among high school pupils in

Ireland (Grube & Morgan. 1988), Britain (Plant et al. 1985; Swadi. 1988;

Cohen. 1989), and the U.S.A. (Johnston et al. 1987). There are probably some elements of under reporting of cannabis use in this study possibly because its use is illegal and generally socially disapproved in Nigeria –

Adelekan et al (1992). In a reported study the authors had to disguise the aim of their study to overcome a high incidence of reluctance in confessing to the abuse of illicit drugs such as cannabis (Olatawura & Odejide, 1974).

The findings of very low use of hallucinogens, cocaine and opiate – heroin is in line with previous epidemiological reports from Nigeria (Smart, 1980;

Adelekan, 1989; Anumonye, 1980; Ihezue, 1988; Asuni and Pela, 1986;

Ogunremi & Okonofua, 1987).

60

6.2 Methodological Strength and Weakness

This study used the Students Drug Use Questionnaire which is a

standardized self-reporting interview instrument by WHO which has been

validated in Nigeria (Adelekan & Odejide 1987). The findings of this study

did not conform with earlier surveys because most of those earlier surveys

employed different questionnaires and they differed in the variety and

number of substances investigated, which could partly explain some of the

differences obtained (Adelekan et al. 1992). In order to ensure better

comparability of results, Adelekan et al. (1992) advised that it is essential

to standardize epidemiological substance use survey instruments

throughout Nigeria. To this effect, the use of the World Health Organization

Substance-use Questionnaire by Smart, has been advocated by Adelekan

and Odejide in 1989. Despite the several uses and relative advantages of

comparability of results by the use of the instrument, a few shortcomings of

the instrument have however been noted. First, as a self-reporting

questionnaire, it is liable to the usual problems of honesty and accuracy of

responses. Secondly, the quantity of substance use and the local

examples or varieties are not specified. Therefore, it is possible that there

was a conceptual problem of measurement error, especially under-

reporting of drug abuse by the respondents.

61

The findings of this study were based on a small sample size due to

financial, manpower and logistic reasons. Furthermore, the author did not

control for socioeconomic variables that could influence the result of this

study.

6.3 Gender and Drug Abuse

The earlier studies on substance abuse in Nigeria did not include

alcohol for investigation. However, subsequent epidemiological studies

confirmed the high prevalence of alcohol in the population, including the

students (Novadomsky, 1982, 1985; Adelekan, 1989, 1992). Although the

initial studies on alcohol use in the country reported a male

preponderance, this trend has since changed with more recent studies

observing no sex difference and an earlier age of onset (Pela, 1988;

Adelekan 1989, 1992). These observations are confirmed by this study

where monthly use of stimulants of 78 percent, weekly use of 16 percent

and daily use of 6 percent by university students were reported.

The use of organic solvents has shown a significant rise in recent

years. In a study by the International Council on Alcohol and Addictions

(ICAA) 1988 in the Southern Nigeria, 23.7 percent of the general

population and 35.7 percent of the students surveyed in Lagos had used

an inhalant at least once in their lives. Similarly, high rates of inhalants

(especially organic solvents) used by young people in the northern part of

the country has also been reported (Obot 1995). In this study 9.6

62

percent of the respondents reported use of inhalants of which two thirds

were females and current use was 6.5 percent. This is close to a lifetime

prevalence rate of 14 percent and 5.5% current use found by Obot (2000)

in a survey of secondary school students in Jos.

6.4 Highlight of Psychosocial correlates

Peer group pressure is a strong initiating force in adolescent drug

use (Peltzer, 1988; NDLEA. 1992, Swadi and Zeitin. 1988). This is

supported by this study where 41 percent of the students initiated drugs “to

be like friends”. Parental influence was demonstrated by some students.

This may be a consequence of economic hardship leading to stress which

push the parents into drug abuse, a behaviour that is in turn emulated by

their children and wards.

The initiation into drug and alcohol use at primary school and early

secondary school levels was 60 percent in this study. This is similar to the

finding by Abiodun et al. (1994). Primary and early secondary school levels

may therefore represent important periods for initiating preventive

strategies amongst Nigerian students.

Most students (43 percent) did not know the reasons for their first

use of drugs; but acceptability and sociability (14 percent) with peer group

pressure ranked as highest reason for their first use of drug and alcohol.

Curiosity, (9 percent) ranked next as reason for their first drug use. This is

because students are still in their formative years and they are

63

impressionable, very inquisitive, experimenting and prone to the many disruptive, physical and psychosocial effects of drug abuse (Pela 1986).

The literacy level of parents in this study was very high: 80 percent had secondary and post secondary education. This enhanced the students’ responses to be intelligible. This finding is similar to that of Obot 2000 where 72 percent of the fathers had secondary and post secondary education, and half of the parents thought that it was either difficult or very difficult for the children to obtain illicit drugs. Also, most parents expressed interest in getting more information about drugs and in getting involved in drug abuse prevention among youths.

64

CHAPTER SEVEN

CONCLUSION

The substances found most commonly used by students in this study fall mainly outside the class of hard drugs. Rather, they comprise the readily available and or socially acceptable ones (Alcohol, cigarettes) and the “classified” substances (Stimulants – Amphetamine and inhalants) as well as hypno-sedatives.

Majority of the users were past users or “experimenters” as well as mild or “occasional users”. Substance use prevention and control programmes in Nigeria should take due note of these and other local findings in the design and implementation of such programmes. There is a need for continuous monitoring of substance use within the country, particularly with regards to hard drugs.

65

REFERENCES

1. Abiodun O. A. M. L Adelekan, O. O. Ogunremi, G. A. Oni, and A. O.

Obayan. Pattern of substance use amongst secondary school

students in Ilorin, Northern Nigeria. West African Journal of Medicine

Vol.13 No.2, April – June, 1994, 91-97.

2. Adamson T. A. (1991): Initial Data on Clinical and social

complications of drug abuse at Aro, Nigeria. Paper presented at Aro,

National workshop on drug abuse.

3. Adamson T. A. & Sijuwola O. A. (2001). Ilewo-Orile Nigeria.

Epidemological study: Psychiatric morbidity in a rural community

using the 12-man GHQ Nigeria Journal of Psychiatry, Vol.1 No.5,

315-321.

4. Adelekan M. L. (1989); Bull Narcot 41 (1,2).109.

5. Adelekan M. L., (1989): Self-reported drug use among secondary

school students in the Nigeria State of Ogun. Bulletin on Narcotics,

41:109 – 116.

6. Adelekan M. L., Abiodun O. A, Obayan A, Oni G, Ogunremi O. C.

(1992): Prevalence and pattern of substance use among

undergraduates in a Nigerian university. Drug A/C. dependence 29:

255-261.

66

7. Adelekan M. L., Abiodun O. A, Obayan A. I. Oni G. A, and Ogunremi

O. O.: Psychosocial correlates of alcohol, tobacco and cannabis use:

findings from a Nigerian university. Drug and alcohol dependence

1993; 33-247.

8. Adelekan M.L, Ndom R.J.E: Trend in prevalence and pattern of

substance use among secondary school pupils in Ilorin, Nigeria. West

African Journal Med. 1997, 16:157-164.

9. Akindele, M. O. (1974): Students and drugs: A study of 39 problem

cases. Paper presented to the Nigerian Medical Association Annual

Conference, Enugu, 25 April, 1974.

10. Akindele, M. O. & Odejide, A.O. (1978). Use and abuse of sleep

inducing Drugs in Ibadan, Afr. J. Psychiat, 4, 91.

11. Anumonye A, Omoniwa N., and Aderanjo H. (1977): Excessive

alcohol use and related problems in Nigeria. Bulletin on Narcotics. Vol

xxxii No.4, 23-30.

12. Anumonye A.(1980): Drug use among young people in Lagos,

Nigeria. Bulletin on Narcotics Vol. xxxii No.4, 39-45.

13. Anochie K. E. O., Nkanginieme F, Eke, E.A.D Alikor: Drug abuse

among secondary school students in Port Harcourt Metropolic.

Nigerian Journal Medicine Vol.8 No.1. Jan – March 1998.

14. Awake Journal Sept. 22, 2004 watch tower Org. 04E9/22

67

15. Awaritefe A & Ebie J. C.(1995): On the strategy for the prevention of

Drug abuse. African Journal of Psychiatry 139 – 144.

16. Asuni T (1964): Socio-psychiatric problems of Cannabis in Nigeria,

U. N. Bull Narcotics 16, No.2,17.

17. Asuni T. & Pela, O.A. (1986) Bull. Narcot. 38 (1,2). 55.

18. Boroffka A (1966): Mental illness and Indian hemp in Lagos, Nigeria.

East Africa Medical Journal 43, 377.

19. Carothers J. C. (1953). The African Mind in Health and Disease. A

study of Ethnopsychiatric, Monograph series, No.17 Geneva: World

Health Organization.

20. Cancrini L.; The Psychopathology of Drug Addiction, Journal of Drug

Issues 24, No.4 (1994), 639 – 656.

21. Cadoret R. J., Cain C. A. (1992), The genetics of alcoholism: The

influences in human substance abuse: Journal of Addictive diseases;

Vol.36, No.5, 635 – 650.

22. Cohen J. (1989). Drug use amongst young people in Tameside,

Greater Manchester, Tameside Education Dept.

23. Crowe, R., Noyes, R., Pauls, D. and Slymen, D. (1983) ‘A family

study of panic disorder’ Archives of General Psychiatry, 40, 1065-

1069.

68

24. Dorothy E.D, Daniels A. G. (1978); Drugs: A factual account Asian

Books Pub. Ltd. Fourth Edition.

25. Ebie J. C. (1988): Report of a research project on substance use in

some urban and rural areas of Nigeria. International Council on

Alcoholism and Addictions. Lausanne, Switzerland, Nigeria Medical

Journal 80, pp. 72-75.

26. Federal Republic of Nigeria (1989) Official Gazette No. 47, Vol. 76,

The Fed. Govt. Press, Lagos.

27. Grant B. F. (1994). Alcohol Consumption, alcohol abuse and alcohol

dependence. The United States as example. Addiction 89, 13571-

369.

28. Gelder, M. Mayou, R, Cown, P. (2001) Shorter Textbook of

Psychiatry. Fourth edition, Oxford University Press, Oxford.

29. German, G.A. (1987) Mental Health in Africa. I: The Extent of Mental

Health Problems in Africa Today. British Journal of Psychiatry,

151,435-439.

30. Grube J.W. & Morgan M. (1986) Smoking, Drinking and other drug

use among Dublin Post Primary School Pupils, The Economic and

Social Research Institute, Dublin.

69

31. Gureje O. Obikoya B. & Ikuesan B.A. (1992): Alcohol abuse and

dependence in an urban primary care clinic in Nigeria. Drug and

Alcohol dependence 30, pp.163-167.

32. Howarth, A. (1982) Bull. Narcot. 34 (3,4), 45.

33. Ifabumuyi, O. O. & Ahmed M.H. (1984). A survey of alcoholism

among outpatients in Kaduna, Nigeria Journal of Psychiatry 1, pp. 45-

49.

34. Ihezue U.H. (1988). J. Nat. Med. Assoc. 80,81: Drug use among

Medical Students at a Nigerian University Part I Prevalence & Pattern

of Use.

35. Jegede R. O. (1980) Personality and Mental Health Characteristics of

Nigeria Students, Acta Psychiatrica Scandinavica, 61, 67-80.

36. Johnston, L., O’Malley, P & Bachman, J. National trends in drug use

and related factors among high school students and young adults

1975-1986, NIDA, Rockville, Maryland, 1987.

37. Kendler J. S; Karkowski, L.M. and Prescott, C.A. (1999). Casual

relationship between stressful life events and the onset of major

depression. American Journal of Psychiatry 156, 837-841.

38. Makanjuola J.D.A. (1986): The Aro drug addiction research and

treatment centre: A first report Brit. J. Addict. 81:809-814.

70

39. Minassian D.C. (1997): Epidemiology in Practice. Sample size

calculated for eye surveys: A simple method. Journal of Community

Eye Health 1997, 10(23): 42-44

40. NDLEA (1991) National Drug Law Enforcement Agency Bulletin for

1991 pp. 26-27.

41. NDLEA (1992) National Drug Law Enforcement Agency Bulletin for

1992 pp. 32-34.

42. Ndom R.J.E. & M.L. Adelekan (1996) Psychosocial correlates of

substance use among undergraduates in Ilorin University, Nigeria.

East African Medical Journal Vol. 73 No.8 5 August 1996. 541-547.

43. Novadomsky J. (1981): Pattern of self-reported Drug use among

Secondary School Students in Bendel State Nigeria, Bulletin on

Naccotics, 33, 9-19.

44. Novadomsky J. (1982): Self-reported drug use among Secondary

School Students in two rapidly developing Nigerian towns. Bulletin on

Nacotics 32: 21-32.

45. Nwama O. C. (1971): Major school offences in Nigeria, preliminary

study. West African Journal of Education 15, pp 99-103.

46. Obot I. S. (1990) the use of tobacco products among Nigerian adults:

a general population survey. Drug and Alcohol Dependence, 26, 203-

208.

71

47. Obot I. S. (2000) Assessment of Drug use among secondary school

students and attitudes of parents in Jos Nigeria, United Nations Drug

Control Programme Nigeria 2000.

48. Odejide A. O. Problems of drug abuse in Nigeria. A review of existing

literature and suggestions on preventive measures. Nigeria Medical

Journal 1980 10: 5-11.

49. Odejide, A. O., Olatawura, M.O. and Adetuyibi A. (1980): Preventive

aspects of Drug Abuse in Nigeria. Prevention in Psychiatry 1, 307-

310.

50. Odejide A. O. and Olatawura M. O. (1977): Alcohol use in a Nigerian

rural community. African Journal Psychiatry 3, 69-74.

51. Odejide, A. O. Ohaeri, J.U., Adelakan M.L. and Ikuesan B.A. (1987)

Drinking behaviour and social change among youths in Nigeria –

Study of two cities. Drug and alcohol dependence 230, 227-233.

52. Odejide A. O. and Sanda A. O. (1976): Observations on drug abuse

in Western Nigeria: African Journal of Psychiatry, 2, p. 303.

53. Odejide A. O., Oyewumi, L. K. Ohaeri J.U. (1989) Psychiatry in Africa.

An overview, American Journal of Psychiatry 146:6, 708-716.

54. Ogunremi O. O.& Okonofua F.E. Abuse of drug among Nigerian

Youths African Journal of Psychiatry 1977; 107-112.

72

55. Okulate, G.T. & Osibogun, A. (2001). Prevalence of anxiety,

depressive and other common mental disorders in a semi-urban

Nigerian Community. Second International Forum on Mood and

anxiety disorders, Monte-Carlo, November 28 – Dec. 1.

56. Oshodin G. O.(1981): Alcohol abuse – a case study of secondary

school students in a rural area of Benin district, Nigeria. Drug and

Alcohol dependence 8, 207-213.

57. Oshodin O.G. & Goyea 1983. Alcohol poisoning among children in

Benin City, Nigeria, Nig. Medical Practitioners, 6: 21-23.

58. Oviasu V. O. (1976); The abuse of Cannabis in Nigeria, Nig. Med. J. 6

p. 369.

59. Pela O.A. (1986) Adolescent alcoholism in Benin City Nigeria.

Adolescence, 21: 487-492.

60. Pela O. A. (1989) Drug abuse and attitudes among College Students

in Benin City, Nigeria. J. Alc. Drug Educ. 34:5-13.

61. Peitzer K. Causative and interviewing factors of harmful alcohol

consumption and Cannabis use in Malawi, African Training Courses

Drug Depend. 1988; 33-42.

62. Plant M., Reck, D & Samuel E. (1985) Alcohol, Drugs and School

leavers, Tavistock, London.

73

63. Riston E. B., Chick, J.D., Strong, J. (1993) Dependence on alcohol

and other drugs in companion to Psychiatric studies, Kendel R.E.,

Zealley A.K., Churchill Livingstone, London 5th edition pp. 359-397.

64. Smart R. G: A methodology for students drug-use surveys, WHO

offset publication, No. 5, WHO Geneva, 1980.

65. Segal, B. E. (1966). Epidemiology of Emotional disturbance among

College undergraduates: a review of analysis, journal of nervous and

mental diseases. 143, 348-362.

66. Swadi H. Zeitlin H. Peer influence and Adolescent Substance abuse:

a promising side? Porit J. addict 1988; 83: 153-157.

67. Stenbacka M. (1992); Adulthood, A longitudinal study – Scandinavia

Journal: 2-22.

68. Tooth G. (1950) Studies in Mental illness in the Gold Coast. Colonial

Research publications no. 6, London, HMSO.

69. Torgersen, S. (1986) – Childhod and family characteristics in Panic

and generalized anxiety disorders, American journal of Psychiatry,

143: 630-632.

70. Tyrer, P. (1988) Personality disorders: Diagnosis, Management and

Course, Essex, Wright.

71. Umunna I. (1977): The drinking Culture of a Nigerian Community:

Onitsha Drug and Alcohol Dependence, 28, pp. 229-237.

74

Appendixes 1

Three schools from each LGA by sex were selected as follows:

OREDO LGA - 1 Female school only – Idia College, Benin

City

1 Male school only - Egosa Grammar School,

Benin City

1 Co-educational – Baptist High Sch. Benin

City.

IKPOBA OKHA - 1 Female School – Maria Gorreti, Benin City

2 Co-educational – Niger College, Benin City

Aduwawa Grammar Sch.,

Benin City

EGOR - 1 Male School - Egor Grammar School,

Benin City

2 Co-educational – Evbareke Grammar Sch.,

Benin City and;

Iyoba Grammar School,

Uselu

75

QUESTIONNAIRES

1. Are you a male or a female

2. What is your age?

3. How many years of school have you completed? (Do not count kindergarten)

4. For most of the last 12months, were you a student, full-time or part-time?

5. For most of the last 12months, have you worked on a paid job, full-time or part-time?

6. For most of the last 12months, have you worked on an unpaid job, full-time or part-time?

FOR EVERY QUESTION YOU MUST READ PARTS (a),(b),(c), AND ANSWER EACH PART

7. (a) Have you ever smoked, chewed, or sniffed any tobacco product (such as cigarettes, cigars, pipe tobacco, chewing tobacco?)

(b) Have you smoked, chewed or sniffed a tobacco product in the past 12months?

(c) Have you smoked, chewed or sniffed a tobacco product in the past 30 days?

(d) How old were when you first smoked, chewed, or sniffed a tobacco product.

A Male B Female

Years

Years

I was not a student during most of the last 12 months I was a part-time student I was a full-time student

I have not worked on a paid job during most of the last 12months. I have worked on a part-time paid job. I have worked on a full-time paid job.

I have not worked on a unpaid job during most of the last 12months. I have worked on a part-time unpaid job. I have worked on a full-time unpaid job.

A Yes B No

A Yes B No

A Yes B No

A I have never smoked, chewed or sniffed tobacco products B 10 years old, or less C 11 – 12 years old D 13 - 14 years old E 15 – 16 years old F 17 - 18 years old G 19 years old, or more

ii

8. (a) Have you ever drunk any alcoholic beverage (including beer, wine, and spirits)

(b) Have you drunk any alcoholic beverage in the past 12months?

(c) Have you drunk any alcoholic beverage during the past 30 days?

(d) How old were you when you first had a drink of beer, wine or spirits – more than just a sip?

9. (a) Have you never taken any cannabis (marijuana, pot, hashish, grass, hang, ganja)?

(b) Have you taken any cannabis in the past 12 months?

(c) Have you taken any cannabis during the past 30 days?

(d) How old were you when you first took cannabis?

10. (a) Have you ever taken any cocaine?

(b) Have you taken any cocaine in the past 12 months

(c) Have you taken any cocaine during the past 30 days.

A Yes B No

A Yes B No

A Yes

iii

B No

A I have never drunk alcohol beverages B 10 years old, or less C 11 – 12 years old D 13 - 14 years old E 15 – 16 years old F 17 - 18 years old G 19 years old, or

A Yes B No

A Yes B No

A No B Yes, on 1-5 days C Yes, on 6-19 days D Yes, on 20 or more days

A Have never taken cannabis B 10 years old, or less C 11 – 12 years old D 13 - 14 years old E 15 – 16 years old F 17 - 18 years old G 19 years old, or

A Yes B No

A Yes B No

A Yes B No

(d) How old were you when you first took cocaine?

iv

11. (a) Have you never taken any amphetamines or other stimulants (uppers, bennies, speed, pep pills, diet pills) without a doctor or health worker telling you to do so?

(b) Have you taken any amphetamines or other stimulants in the past 12 months without a doctor or health worker telling you to do so?

(c) Have you taken any amphetamines or other stimulants during the past 30 days without a doctor or health worker telling to do so?

(d) How old were you when you first took an amphetamine or other stimulants without a doctor or health worker telling you to take it?

(e) If you have ever taken amphetamines or other stimulants, write in the name of the one you have taken most recently

12. (a) Have you ever taken any hallucinogens (LSD, mescaline, peyote, psilocybin, PCP)?

(b) Have you taken any hallucinogens in the past 12 months?

A Have never taken cocaine B 10 years old, or less C 11 – 12 years old D 13 - 14 years old E 15 – 16 years old F 17 - 18 years old G 19 years old, or

A Yes B No

v

A Yes B No

A No B Yes, on 1-5 days C Yes, on 6-19 days D Yes, on 20 or more days

A Have never taken amphetamine B 10 years old, or less C 11 – 12 years old D 13 - 14 years old E 15 – 16 years old F 17 - 18 years old G 19 years old, or more

A Yes B No

A Yes B No

(c) Have you taken any hallucinogens during the past 30 days?

(d) How old were you when you first took hallucinogens?

vi

(e) If you have ever taken hallucinogens, write in the name of the one you took most recently

13. (a) Have you ever sniffed or inhaled things (such as glue, aerosol sprays, or other gases) to get high? (Do not include smoke)

(b) Have you sniffed or inhaled things to get high in the past 12 months?

(c) Have you sniffed or inhale things to get high during the past 30 days?

(d) How old were you when you first sniffed or inhaled something to get high?

(e) If you have ever sniffed or inhaled things write in the name of the things you have sniffed or inhaled most recently?

14. (a) Have you ever taken any tranquilizers (Librium, Valium, Miltown) without a doctor or health worker telling you to do so?

A No B Yes, on 1-5 days C Yes, on 6-19 days D Yes, on 20 or more days

A Have never taken hallucinogens B 10 years old, or less C 11 – 12 years old D 13 - 14 years old E 15 – 16 years old F 17 - 18 years old G 19 years old, or more

vii

A Yes B No

A Yes B No

A No B Yes, on 1-5 days C Yes, on 6-19 days D Yes, on 20 or more days

A Have never sniffed or inhaled anything to get high B 10 years old, or less C 11 – 12 years old D 13 - 14 years old E 15 – 16 years old F 17 - 18 years old G 19 years old, or more

A Yes B No

viii

(b) Have you ever taken any tranquilizers in the past 12months without a doctor or health worker telling you to do so?

(c) Have you ever taken any tranquilizer during the past 30 days without a doctor or health worker telling you to do so?

(d) How old were you when you first took a tranquilizer without a doctor or health worker telling you to take it?

(e) If you have ever taken tranquilizers write in the name of the one you have taken recently

15. (a) Have you ever taken any sedatives (barbiturates, downers, goofballs, seconal) without a doctor or health worker telling to do so?

(b) Have you taken any sedatives in the past 12 months without a doctor or health worker telling you to do so?

(c) Have you taken any sedatives during the past 30 days without a doctor or health worker telling you to do so?

(d) How old were you when you first took a sedative without a doctor or health worker telling you to do so?

(e) If you have ever taken sedatives write in the name of the one you have taken most recently

A Yes B No

A No B Yes, on 1-5 days C Yes, on 6-19 days D Yes, on 20 or more days

ix

A Have never taken tranquilizers B 10 years old, or less C 11 – 12 years old D 13 - 14 years old E 15 – 16 years old F 17 - 18 years old G 19 years old, or more

A Yes B No

A Yes B No

A No B Yes, on 1-5 days C Yes, on 6-19 days D Yes, on 20 or more days

A Have never taken sedatives B 10 years old, or less C 11 – 12 years old D 13 - 14 years old E 15 – 16 years old F 17 - 18 years old G 19 years old, or more

x

16. (a) Have you ever smoked or eaten any opium without a doctor or health worker telling you to do so?

(b) Have you smoked or eaten any opium in the past 12months without a doctor or health worker telling you to do so?

(c) Have you smoked or eaten any opium during the past 30 days without a doctor or health worker telling you to do so?

(d) How old were you when you first smoked or ate opium without a doctor or health worker telling you to do so?

17. (a) Have you ever taken any heroin (horse, smack, H)?

(b) Have you taken any heroin in the past 12 months

(c) Have you taken any heroin during the past 30 days?

(d) How old were you when you first took heroin?

A Yes B No

A Yes B No

xi

A No B Yes, on 1-5 days C Yes, on 6-19 days D Yes, on 20 or more days

A Have never smoked or eaten opium B 10 years old, or less C 11 – 12 years old D 13 - 14 years old E 15 – 16 years old F 17 - 18 years old G 19 years old, or more

A Yes B No

A Yes B No

A No B Yes, on 1-5 days C Yes, on 6-19 days D Yes, on 20 or more days

A Have never smoked or eaten heroin B 10 years old, or less C 11 – 12 years old D 13 - 14 years old E 15 – 16 years old F 17 - 18 years old G 19 years old, or more

xii

18. (a) Have you ever taken any other opiate (methodone, morphine, codeine, demerol, paregoric) without a doctor or health worker telling you to do so?

(b) Have you taken any of these other opiates in the past 12 months without a doctor or health worker telling you to do so?

(c) Have you taken any of these other opiates during the past 30 days without a doctor or health worker telling you to do so?

(d) How old were you when you first took any of these opiates without a doctor or health worker telling you to do so?

19. (a) Are there any other drugs not mentioned that you have taken in the past year without a doctor or health worker telling you to do so?

(b) If yes, write in the name of the drug or drugs

20. (a) Do you know of any other drugs that people are now taking to make them feel good or intoxicated?

(b) If yes, what are these drugs called?

21. If you had ever used any cannabis, would you have admitted it in this questionnaire?

22. If you had ever used any opium or heroin, would you have admitted it in this questionnaire?

xiii

A Yes B No

A Yes B No

A No B Yes, on 1-5 days C Yes, on 6-19 days D Yes, on 20 or more days

A Have never smoked or eaten opiates B 10 years old, or less C 11 – 12 years old D 13 - 14 years old E 15 – 16 years old F 17 - 18 years old G 19 years old, or more

A Yes B No

A Yes B No

A No B Not Sure C Yes

A No B Not Sure C Yes

xiv

23. Route of drug administration What methods have you used for taking heroin? (mark all that apply)

24. Source of introduction to drug use Who introduced you to non-medical drug use? (please check one box only)

25. Reason for first non-medical drug use What was the reason for you first non-medical drug use? (please check one box only)

26. A. Where do you live now?

B. How much education did your father receive? (mark the highest level attended)

xv

Sniffing or “snorting” Smoking Injection By mouth Other (please specify)

Family Casual acquaintance Friends Drug pusher Doctor (physician) Other health practitioner Pharmacist or druggist Other (please specify) Don’t know

Religious custom To be accepted by others To be sociable Enjoyment Enhancement of sex Curiosity Treatment of health disorder Relief of psychological stress Relief of cold, hunger, or fatique Improvement of work performance Other (please specify) Don’t know

On a farm or in a village In a small or medium level sized city or town In a suburb of a large city In a large city

No formal schooling Primary school Secondary or high school University or other post secondary education

xvi

Don’t know

xvii

C. How much education did your mother receive? (mark the highest level attended)

27. Approval or disapproval of drug use Individuals differ in whether or not they disapprove of people doing certain things. Do you disapprove of people (who are 18 or older) doing the following? (mark one box for each question)

A. Smoking 20 or more cigarettes a day

B. Trying marijuana (cannabis, pot, grass) once or twice

C. Smoking marijuana occasionally

D. Smoking marijuana regularly

E. ………………………………………. (other drug-related behaviour of interest to the investigator)

28. Perceived availability How difficult do you think it would be for you to get each of the following types of drug, if you wanted some (mark one box for each question)

A. Marijuana (cannabis, pot, grass)

No formal schooling Primary school Secondary or high school University or other post secondary education Don’t know

xviii

Don’t disapprove Disapprove Strongly disapprove

Don’t disapprove Disapprove Strongly disapprove

Don’t disapprove Disapprove Strongly disapprove

Don’t disapprove Disapprove Strongly disapprove

Don’t disapprove Disapprove Strongly disapprove

Probably impossible Very difficult Fairly difficult Fairly easy Very easy

xix

B. Amphetamines and other stimulants

C. ………………………………………. (other drug of interest to the investigator)

29. The sort of people who use drugs Drug use has different meanings for different people. We want to know how you think most people of your age view others who use various drugs. Most people of my age believe that those who use marijuana and other such drugs are:

A. Ambitious

B. Antisocial

30. Personal history – Upbringing Where you brought up by your parents till you were about 10 years old?

31. Religion Islam Christianity African Traditional Others (specify)

Probably impossible Very difficult Fairly difficult

xx

Fairly easy Very easy

Probably impossible Very difficult Fairly difficult Fairly easy Very easy

Much less than average Less than average About average More than average Much more than average

Much less than average Less than average About average More than average Much more than average

Yes No

xxi

32. Family harmony Is your family harmony

33. Offenses Have you committed any of these offenses?

34. Cult activity Do you belong to any cult?

35. If yes, does initiation involve drug use

36. Family background Monogamous (father has one wife). Polygamous (father has more than one wife)

37. Position in family (by mother)

38. How do you assess your experience as you grew up till now.

xxii

Good Fair Poor

Assault Stealing Robbery Fraud

Yes No

Yes No

1st Child 2nd Child 3rd Child 4th Child Others specify……………..

Good Fair Poor

xxiii