Background to the Study
Globally, people abuse substances such as drugs, alcohol, tobacco and psychoactive substances for varied and complicated reasons, but it is clear that our society pays a significant cost. The toll for this abuse can be seen in our hospitals and emergency departments through direct damage to health by substance abuse and its link to physical and mental trauma. Jails and prisons tally the strong connection between crime, drug dependence and abuse. Substance abuse patterns though varied among youth populations across regions of the world are unprecedented and alarming (United Nations Office on Drugs and Crime, 2007). In Nigeria, this social malady is considered an issue of serious public health concern as it adversely affects the lives and performance of secondary school students involved as well as the harmonious functioning of entire structure of the society (Bachman, Schlenberg & Malley, 2011).
Substance has been variously defined in literature. Conceptualizing substance in this study offers profound insights into substance abuse. Hornby (2010) defines substance as a physical material from which something is made or which has discrete existence. He further refers to substance as an intoxicating, stimulating, or narcotic chemical or drug, especially an illegal one. Examples of substances include insulin, heroin, amphetamines, and cocaine. Due to availability and accessibility to these substances, individuals especially adolescents are more vulnerable to their overt or covert abuse (World Health Organization-WHO, 2012).
Abuse has been defined as the use of something in a way that is wrong or harmful (Hornby, 2010). WHO (2012) referred to abuse as non-medical or unsanctioned patterns of use, irrespective of consequences. When psychoactive substances are used in unsanctioned patterns, a phenomenon known as substance abuse ensues. The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) issued by the American Psychiatric Association (APA), the DSM-IV-TR, defines substance abuse as a maladaptive pattern of use indicated by continued use despite knowledge of having a persistent or recurrent social, occupational, psychological or physical problem that is caused or exacerbated by the use (or by) recurrent use in situations in which it is physically hazardous (American Psychiatric Association, 1994). It is a residual category, with dependence taking precedence when applicable.
Health Officers Council of British Colombia-HOC (2005) asserted that substance abuse also known as drug abuse is a patterned use of a substance (drug) in which the user consumes the substance in amounts or with methods neither approved nor supervised by medical professionals. Substance abuse or drug abuse is not limited to mood-altering or psychoactive drugs. If an activity is performed using the object against the rules and policies of the matter (as in steroids for performance enhancement in sport) it is also substance abuse. Therefore, mood altering and psychoactive substances are not the only types of drug abuse. Use of illicit drugs like narcotics, stimulants, depressants, (sedatives), hallucinogens, cannabis, even glues and paints are also considered to be classified as drug or substances abuse. Substance abuse often includes problems with impulse control and impulsive behaviours.
Substance abuse is also defined by United Nations International Drug Control Programme-UNIDCP (2007) as taking of substances without medical justification. This definition used by United Nations International Drug Control Programme is associated with taking of drugs without a physician’s prescription or advice which is dangerous to one’s health. In the same vein, National Institute on Drug Abuse-NIDA (2007) defined substance abuse as drug use that results in physical, mental, emotional and social impairment of the user. NIDA refers to the use of any drug to the point that it interferes with the individual’s health or with his economic or social adjustments as amounting to an abuse of such drug. Rahim (2010) defined substance abuse as self-administration of a drug for non-medical reasons, in quantities and frequencies which may impair an individual’s ability to function effectively, and which may result in social, physical, or emotional harm. Within the context of this study, substance abuse is conceptualized as the excessive and persistent self-administration of a drug or substance without regard for medically, culturally or socially accepted patterns. It is also seen as the use of performance enhancing drugs or substances for non-medical effects to the extent that it interferes with the health of an individual.
Drugs are an integral part of substances that are commonly abused. Drug abuse and substance abuse are synonymous though the former is used as a blanket term in APA’s (1994) DSM-IV-TR to incorporate other psychoactive substances. Also, the terms have been extensively used interchangeably in literature and non-medical contexts (Keane, Reaper-Reynolds, Williams, & Wolfe, 2006; Nutt, King, Saulsbury & Blakemore, 2007). Substances have been conceptualized by experts in medical science and public health in different perspectives though there is a common conceptual focus. Achalu (2004) defined substance as any material that composed chemical elements or constituents other than food that when taken into the body alters the structure or function of the body in some ways. He further affirmed that substances are chemicals or designed for the prevention or cure of disease or for relief of pain and discomfort. substances also include any natural or synthetic substance that can stimulate, suppress or alter the body’s structure and biological functions.
Achalu (2004) further stated that substances have been classified according to their effects on the body. These include; those that prevent disease; those that fight infections; those that affect the heart and blood vessels; those that affect the nervous system; those that correct imbalances in the body chemistry; those that relieve pain. The categories of drugs that affect the nervous system incidentally are the most widely abused. This is because they alter mood and feelings. These include analgesics, stimulants, depressants (tranquilizers and barbiturates), hypnotics, and hallucinogens. WHO (2008) defined drugs as any substance solid, liquid or gas which when introduced into the body changes the function or structure of the body in some way. Often, the term “substance use” is preferred, so that all things that affect the way a person feels, thinks, sees, tastes, smells, hears and behaves are included. Thus, glue is a substance used by many street children and methamphetamines are substances used by many adolescents who go to discos and bars. Sometimes the phrase “psychoactive substance” is used for drugs to emphasize the fact that they affect the central nervous system and alter mood, thinking, perception and behaviour (Hussein-Rassool, 1998). United Nations International Drug Control Programme-UNIDCP (2007) opined that drugs are in synthetic forms that affect the organism by altering its mood or behaviour. In addition, substances can be licit or illicit.
Licit substances are substances which have been determined to be safe, effective and given under the direction of a physician or any member of the health team for medical purposes only. Conversely, illicit substances are materials whose manufacture, sale, distribution, purchase for sale or possessions are prohibited by law. These include substances such as cannabis sativa, cocaine, heroin, and amphetamine among others. Though, the crux of this study centers on substance abuse patterns, there is a nexus between this concept and other critical concepts associated with substances/drugs, which include drug use and misuse. Drug use is a broad term to cover the taking of all psychoactive substances within which there are stages: drug-free (that is, non-use), functional use, experimental use, dysfunctional use, recreational use and harmful use, which is further sub-divided into misuse and dependence. Substance misuse is defined in APA’s (2000) DSM-IV-TR as any taking of a drug which harms or threatens to harm the physical or mental health or social well-being of an individual or other individuals or society at large, or which is illegal. Furthermore, there are myriads of drugs or substances that are commonly abused by adolescents including secondary school students in Bauchi Education zone. An expatiation on categories and examples of psychoactive drugs, other substances and associated consequences will facilitate ample comprehension of substance abuse patterns among secondary school students.
There exists considerable number of substances that are commonly used and abused by adults, youths, and adolescents including secondary school students in Bacuhi Education Zone. The generic name of a drug is standard and used throughout the world. However, most drugs are marketed under various trade names and also have many street names. Trade names usually begin with a capital letter. For example, a commonly used drug to reduce anxiety is diazepam (generic name) and is sold in some countries as Valium (trade name). Another example is diacetylmorphine, which is the generic name for Heroin, and has the street names, “brown sugar” in India, and “smack” in the USA and Australia. It is also common for street names to change regularly. The three main types of psychoactive drugs, classified by their effects on the central nervous system are: depressants, Hallucinogens, Stimulants. Other categories include inhalants and solvents, ecstasy and over the counter drugs-OTC (UNODC, 2007; WHO, 2008; European Monitoring Centre for Drugs and Drug Addiction-EMCDDA, 2012). This study adopts this classification.
Depressants slow down, or depress, the central nervous system. They do not necessarily make the user feels depressed. Depressant drugs include: alcohol, opiates and opioids including heroin, morphine, codeine, methadone, and pethidine. Cannabis including marijuana, hashish, hash oil, tranquillizers and hypnotics (Rohypnol, Valium, Serepax, Mogadon, and Euhypnos), and barbiturates (Seconal, Tuinal and Amytal). Cannabis, commonly known as the dried plant form of marijuana, can have a slight effect on one person and a much greater effect on another person. The initial effect for a new marijuana smoker can be a strong rush. There are negative health effects which result from abuse. Marijuana comes from the hemp plant, Cannabis sativa, which grows throughout most of the world. The cannabis plant is prepared for consumption in various ways. Three common forms of cannabis are marijuana, hashish, and hashish oil.
The term marijuana refers to the cannabis plant and to any part or extract of it that produces somatic or psychic changes. Drying the leaves and flowering-tops of the plant produces the tobacco-like substance. Hashish and hash oil are prepared from the resin of the cannabis plant. Some people become psychologically dependent on marijuana and must exert considerable effort or even obtain medical treatment to stop using it. When marijuana is smoked, the effects are felt within minutes, reach their peak in 10 to 30 minutes, and may linger for two or three hours. The most obvious and verified effect of marijuana on humans is a dose-related, temporary increase in heart rate, as high as 160 beats per minute. A reddening of the eyes is also a common physiological reaction to acute marijuana use. A “high” from cannabis can last for several hours. During this time’ most users feel relaxed and self-confident, and have altered perceptions of time and space. Some new users and heavy users experience confusion, anxiety and panic (Hussein Rassool, 1998; EMCDDA, 2012).
When a person is marijuana-intoxicated, he/she shows many indications of impaired psychological functioning, including effects on memory, thinking, speaking, various kinds of problem solving, and concept formation. Most of these effects seem to share in common an impairment of short-term memory the leads to fragmented speech, disjointed thinking and a tendency to lose one’s train of thought. Some new users, particularly adolescents and people who use a lot regularly, can experience psychosis. Long-term heavy cannabis use is likely to have negative effects on health. These include: respiratory diseases such as bronchitis and cancers commonly associated with smokers, loss of memory and mental capacity, potential risk to children when women use cannabis during pregnancy (Keane, Reaper-Reynolds, Williams, & Wolfe, 2006; WHO, 2012). Marijuana users in secondary school students are susceptible to these diseases while their academic performance is jeopardized due to memory loss and impair mental capacity.
Hallucinogens distort perceptions of reality. Examples of the drugs include: LSD (lysergic acid diethyl amide); trips, acid, microdots, Magic mushrooms (psilocybin): gold tops, mushies, Mescaline (peyote cactus), Ecstasy (MDMA/methylenedioxymethamphetamine). Cannabis in stronger concentrations, such as in hashish and resin can act as an hallucinogen in addition to being a central nervous system depressant; Ketamme also known as K or and Special K. The main physical health effects of hallucinogenic drugs are dilation of pupils, loss of appetite, increased activity, talking or laughing, jaw clenching, sweating and sometimes, stomach cramps and nausea. Drug effects can include a sense of emotional and psychological euphoria and well-being. Visual, auditory and tactile hallucinations may occur; causing users to see or hear things that do not actually exist. The effects of hallucinogens are not easy to predict. The person may behave in ways that appear irrational or bizarre. Psychological effects often depend on the mood of the user and the context of use. Negative effects of hallucinogens can include panic, paranoia and loss of contact with reality (EMCDDA, 2012). Use and abuse of hallucinogenic drugs by secondary school students exposes students to potent dangers such as mental and social dysfunction with devastating impacts on mental, social, emotional and physical health and truncation of goals secondary school education. Such students constitute significant threats to the staff and students of any given school (Shokunbi, 2000; Ajala, 2010).
LSD (Lysergic Acid and Diethylamide) is the best known of the hallucinogens. As a synthetic drug, it is one of the most potent mind-altering chemicals. LSD is most commonly seen in tablet form or the tablet incorporated into some other dose form, such as, a capsule or occasionally confectionery. LSD appears to cause little or no physical dependence with no withdrawal symptoms having been observed, even after long periods of use. However, users can develop psychological dependence.
Stimulants are used by millions of people every day. Coffee, tea and cola drinks contain caffeine, which is a mild stimulant. The nicotine in tobacco is also a stimulant, despite many smokers using it to relax. Other stimulant drugs, such as ephedrine, are used in medicines for bronchitis hay fever and asthma. Amphetamines and other ATSs (Amphetamine-type Stimulants, such as, forms of methamphetamine known as “ice”, “shabu”, and “ya ba”) and cocaine are illegal in most countries including Nigeria. The use of ATS is becoming a major problem in most countries and has begun to overshadow heroin use in some countries (EMCDDA, 2012). Stimulants speed up or stimulate the central nervous system and can make the user more awake, alert or confident.
Stimulants increase heart rate, body temperature and blood pressure. Other physical effects include reduced appetite, dilated pupils, talkativeness, agitation and sleep disturbance. Abuse of stimulants over stimulates the user, causing anxiety, panic, seizures, headaches, stomach cramps, aggression and paranoia. Prolonged or sustained use of strong stimulants can also cause these effects. Strong stimulants can mask the effects of depressant drugs, such as alcohol. This can increase the potential for aggression and poses an obvious hazard if the person is driving. Mental health difficulties such as psychosis can be associated with problematic ATS abuse (Hussein Rassool, 1998; EMCDDA, 2012). Use and abuse of stimulant and ATS drugs by secondary school students exposes students to health risks which impinge on their mental, social, emotional and physical health dimensions of the users. Abuse of stimulants by secondary school students may culminate into psychosis and paranoia. Thus, psychotic and paranoid students are a threat to teaching-learning processes in any given secondary school.
Cocaine mainly comes in a white powder called cocaine hydrochloride. Cocaine in this form is usually snorted or injected. Cocaine is often mixed with other substances, such as, mannitol or some other sugar to increase the profitability of a deal. Effects of cocaine, which can last for minutes or hours, happen very quickly and can include an extreme feeling of well-being, increased heart rate, agitation, sexual stimulation, alertness, energy, unpredictability and aggressive behaviour. The inside of the nose can be severely damaged if it is regularly inhaled cocaine through the nose. Cocaine or coke is highly dependency creating and, as with other stimulants, reduces hunger, thirst and natural needs for rest, food and water. Death can occur as a result of overdose or an accident (Keane, Reaper-Reynolds, Williams, & Wolfe, 2006; WHO, 2012).
Methamphetamine is an ATS. The use of methamphetamine produces similar, but mostly stronger behavioural and physiological effects to cocaine and other stimulants. These effects include euphoria, increased alertness, the perception of improved self-esteem and self-confidence, impaired judgment, and impulsiveness. Acute and chronic use of methamphetamine typically results in nervousness, irritability, restlessness, and insomnia. The major difference between cocaine and methamphetamine is duration of action. The half-life for cocaine’s euphoric effects is less than 45 minutes, for methamphetamine it is three to six hours. Therefore, the period of stimulant-induced euphoria may be much longer in methamphetamine users, and likewise, the period of impaired judgment will be longer. Permanent neurological changes and deficits can result from chronic methamphetamine use. Use and abuse of cocaine and methamphetamines by secondary school students exposes students to potent dangers such as mental and social dysfunction with devastating impacts on mental, social, emotional and physical health and truncation of goals secondary school education. Such students constitute significant threats to the staff and students of any given school (Shokunbi, 2000; Ajala, 2010).
Solvents and inhalants include petrol, glue, paint thinners and lighter fluid. Some subtances turn to gas in the air and when the fumes are inhaled can cause the user to feel high. These are inhalants. Many household products are used as inhalants such as glue, aerosol spray cans, lighter fluid, paint thinner, chrome based paint or petrol. After a high the drug slows down the central nervous system or the messages going to and from the brain to the body. The drug in some of these products can cause heart failure particularly if the user is stressed or does heavy exercise.
The chemical Methylenedioxymethamphetamine (MDMA) is an example of ecstasy. Ecstasy is a substance that can cause users to see things that are not seen by other people and produces a feeling of tranquility, increased confidence and feeling close to people, which is why it is also known as the love drug. Users can also experience jaw clenching, teeth grinding, dry mouth and throat, nausea and loss of appetite, anxiety, paranoia and confusion. Ecstasy is regarded as a dangerous substance for people with heart or breathing conditions or with depression or psychological disorders. Abuse results in very high blood pressure, increased heartbeat and body temperature. Many people take ecstasy at dance or rave parties (EMCDDA, 2012).
Ecstasy can raise the body temperature to dangerous levels. Not much is known about the long-term effects of ecstasy, but there is some suggestion that it may damage some types of brain cells. Gamma-hydroxybutyrate (GHB), also known as liquid ecstasy, is a depressant drug, which works by slowing down the activity of the brain and central nervous system. GHB commonly exists as a colourless, odourless liquid usually sold in small bottles. It has also has been seen in powder and capsule form. It is mostly taken orally. However, it can be injected. The effects of GHB include: euphoria, drowsiness, nausea, increased confidence, and dizziness. With increased doses, the initial euphoria is replaced by powerful sedative effects, which can include: confusion, agitation, hallucinations, seizures, vomiting/nausea, stiffening of muscles, disorientation, convulsions, unconsciousness /coma, and respiratory collapse. Users can become both physically and psychologically dependent on GHB. Prolonged use of high doses of GHB may lead to withdrawal symptoms. Confused, agitated and disoriented students cannot learn effectively in any academic setting (UNODC, 2007; WHO, 2008).
Heroin is derived from the opium poppy and usually comes in a rock or powdered form that is generally white or pink/beige in colour. The purity of heroin sold on the street can vary enormously from as low as 25-30 per cent to 85-90 per cent depending on fluctuations in the unpredictable illegal drug market. It is a powerful painkiller that is widely used by doctors to treat pain in cancer and heart attack patients. Used medically, pure heroin is a relatively safe drug. Pure heroin is a white powder. Heroin can be smoked, sniffed or injected. It is rarely swallowed, as this method is relatively ineffective. When heroin is heated over a candle or a match on a piece of tin foil or a spoon, the smoke generated is inhaled, often through a small tube (known as “chasing the dragon”). Injection directly into the veins gives an immediate short-lived pleasurable sensation (known as a “rush”). Heroin is the most commonly injected illegal drug. Some long-term effects include constipation, menstrual irregularity and loss of sex drive.
Impure street heroin is usually a mixture of pure heroin and other substances, such as sugar. This is very poisonous. Impure heroin causes collapsed veins, tetanus, abscesses and damage to the heart, lungs, liver and brain. Heroin dependence is extremely expensive and is a major reason for many crimes, as the dependent heroin user needs more money to support the “habit” and just feel normal. Life can become an endless circle of finding money, obtaining the drug and usage (Keane, Reaper-Reynolds, Williams, & Wolfe, 2006; UNODC, 2007; WHO, 2008). Another drug category that is commonly abused by adolescents includes over-the-counter drugs (OTCs).
OTCs are substances intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease. Center for Drug Evaluation and Research-CDER (2010) defined OTCs as substance forms of medications that are available at local pharmaceutical stores without a medical doctor’s prescription. OTCs tend to have more benefits for the abuser because they are easy to select and use without the help of health expert. In the same vein, OTC drugs are defined as safe and effective for use by the general public without a doctor’s prescription (United States Food and Drug administration, 2011). OTCs play an increasingly vital role in healthcare system and are the most prevalent means of treating the majority of common health problems in the world (USFDA, 2011).
There are over eighty therapeutic categories of OTCs which can be grouped into twelve broad therapeutic classes, namely: analgesics and antipyretics (Ibrupren, Aspirin and Naproken sodium), cold, cough, and allergy products (Piriton, phenergan, and pseudoephedrine), nighttime sleep-aids, gastrointestinal products, dermatological products, other topical products (including dermal and vaginal anti-fungal, anorectal medications, head lice products, hair loss products, and otics), ophthalmic products, oral health care products, menstrual products, nicotine replacement products, weight loss aids, vaginal contraceptives and emergency contraceptives (Schneider, 2010; United States Food and Drug Administration, 2011).
The benefits of OTCs availability include: direct, rapid access to effective medicines, wide availability, decreased healthcare system utilization (fewer physician visits, lower healthcare system costs), and allowing individuals to be in charge of their own health. However, there are risks associated with OTC use, such as incorrect self-diagnosis delaying diagnosis and treatment of serious illnesses (delay in seeking advice from a healthcare professional), increased risk of drug-drug interactions, increased risk of adverse events when not used appropriately and potential for misuse and abuse (WHO, 2000; Brass, 2001). As a result of the ostensibly harmless nature, availability and accessibility of secondary school students to OTCs, the tendency to abuse them is overwhelming. If abused, even common over-the-counter medications, such as aspirin, vitamins, or cold remedies can be harmful. For example, abuse of laxatives and enemas for longer than the label indicates can lead to inability to form normal stools while abuse of antacids (Ranitidine and Cemitidine) may produce magnesium toxicity in patients with renal kidney problems or may add extra sodium to the diet which can cause problems with high blood pressure or heart failure (USFDA, 2011). Literature (Achalu, 2004; Ajala, 2010; Keane, Reaper-Reynolds, Williams, & Wolfe, 2006; UNODC, 2007) reveals that prevalence of substance abuse among adolescents has been attributed to certain demographic, environmental and personal factors.
An important contributory factor to substance abuse among secondary school students is availability and nature of the substance. Some environmental factors that contribute to substance abuse are cultural factors, peer attitude toward drug abuse, parents’ behaviour, and regulations and policies, which restrict access to the substances. One of the worst factors in substance abuse is that adolescents and youth are more susceptible to it. This is because adolescence is a period of curiosity, experiencing, and seeking for personal identity (UNODC, 2007; EMCDDA, 2012). Transition from childhood to adolescence is a delicate period and in many cases the initiation of substance abuse occurs in this period. The adolescents may abuse substances due to various reasons, which include lack of adequate knowledge about the harmful effects of the substances, incorrect attitude toward drugs and addiction, presenting personal independence, peer pressure, satisfying the curiosity, low levels of self-confidence, inability in maintaining interpersonal communications, and stress reduction measure. In general, a combination of personal and familial factors, and the conditions of school and the society play an important role in substance abuse in secondary school students. Presence of a substance abuser in the family, the ways the family controls the adolescent, interpersonal communications in the family, level of emotional dependence between parents and children, and the expectations of parents from their children are factors effective on substance abuse by adolescents. Moreover, the type of experience of an adolescent from the school is equally important in this regard (Doncho Donev & Kragelj, 2007; Geramian, Akhavan, Gharaat, Tehrani, & Farajzadegan, 2012).
Regardless of tenability or untenability of factors that predispose secondary school students to this social malady, its social, health, economic and educational burdens on human societies and institutions cannot be over-emphasized (UNODC, 2007; Ajala, 2010). Psychoactive drugs and other substances have been abused in an unprecedented manner by adolescents for non-therapeutic and non-medical purposes in different patterns (Keane, Reaper-Reynolds, Williams, & Wolfe, 2006; EMCDDA, 2012).
Schwart (1993) described pattern as designs or guides, which appear among people. Therefore, it is a regular way in which something happens or is done. Similarly, Gamma (1994) refers to patterns as the designed forms that something may take. Hornby (2001) views patterns as the regular way in which something happens or is performed. Moreover, there are several types of patterns. Pridemore, Andrew and Spivak (2003) classified patterns into three forms. These are spatial, temporal and demographic.
A spatial pattern is a perceptual structure, placement, or arrangement of objects on earth. It also includes the space in between those objects. Patterns may be recognized because of their arrangement; maybe in a line or by a clustering of points. Three classifications are often used when discussing spatial patterns, aggregated (or clustered), random, and regular (Tabrizi, & Madanipour, 2006). Pridemore, Andrew and Spivak (2003) further described spatial pattern based on the geographical locations in a particular country, which could be divided into economic and administrative regions or a result of a mix of structural and cultural forces. Office of Management Budget-OMB (2003) subscribed to Pridemore, Andrew and Spivak’s (2003) definition of spatial when it stated that geographic pattern could be based on country type, which reflects different levels of urban city and metropolitan area. In this study, spatial pattern of substance abuse can be exemplified as the secondary school students’ persistent and excessive use substances in socially unacceptable manner in their immediate environment, which encompasses individuals (animate objects) and school facilities (inanimate objects). In this study, the researcher uses spatial pattern to denote places or settings where substance abuse is usually exhibited among secondary school students in Bauchi Education Zone.
Temporal pattern is described as pattern that has to do with time. The related variables are seasons, months, years, weekends and public holidays. In this study, temporal variable will be used to mean the time span in which students abuse substances, such times include weekends, morning or evening periods, days of the week, rainy seasons and dry seasons, Christmas or Sallah and public holidays (Pridemore, Andrew & Spivak, 2003). Time frame or period as a variable may be implicated in pattern of substance abuse by students as observed by Omigbodun and Babalola (2004) who reported that while some students abuse up to five kegs of palm wine once a week, smokers smoke three sticks of cigarettes per day whereas those who take cannabis smoked three wraps daily. Dinah and Gire (2005) in the study of health and economic consequences of alcohol use in Central Nigeria found out that students drink alcohol daily.
Demographic pattern as described by Pridemore, Andrew and Spivak (2003) will be used in this study to refer to the age, sex, gender and level of education of students who abuse substances. The adoption of age, gender and level of education (class) in this study is necessary because they will provide insight to trend of substance abuse among the students.
Age is a factor that has been implicated in psychoactive substance abuse by students in literature (WHO, 2008; Oshodi, Aina, & Onajole, 2010; Doncho-Donev & Kragelj, 2007; Geramian, Akhavan, Gharaat, Tehrani, & Farajzadegan, 2012). Available epidemiological surveys showed that the abuse of psychoactive substances especially of cannabis and stimulants in western Nigeria involved young adults between 12 and 20 years of age (Oshodi, Aina, & Onajole, 2010). However, age variation of drugs usage may be the same among secondary schools students in Bauchi Educational Zone, Bauchi State.
Gender has influence on patterns of substance abuse. Study (Parry, et al., 1997) had indicated that alcohol and other drug use is more prevalent among males than females. Gender differences, however appear to be less marked for drugs such as heroin and cocaine. Johnson et al. (1993) confirmed that except for cigarettes, boys tend to initiate drug use before girls. Although, there is inconsistency in the substances commonly abused by students as indicated in the report, the actual situation of substance use by gender among secondary schools students in Bauchi Educational Zone will be determined in this study. The inconsistencies in the variation of frequencies in the substances that are abused are worrisome and this will be determined among students in Bauchi Education Zone. Age, gender, class, spatial (location) and temporal pattern (time frame) are variables that could influence substance abuse among secondary school students in Bauchi Education Zone. Recent studies have shown that considerable proportion of youths (secondary school and university students inclusive) are involved in substance abuse despite efforts to discourage them from such destructive practices (Oshodi, Aina, & Onajole, 2010).
The involvement of religious institutions, schools, families, boy scouts and other Non-governmental organizations (NGOs) on the sensitization programme on substance abuse among youths could probably lead to long-term sustainable solutions. However, investigation of patterns of substance abuse among secondary school students including students in Bauchi Educational Zone presents a unique problem for the following reasons. Substance abuse patterns vary across diverse landscapes due to variations and heterogeneity of cultural, social, religious and economic constitutions of any given population. Consequently, the prevailing patterns of substance abuse among secondary school students in Bauchi Education Zone may be different from established patterns in other regions of the country.
Secondary school students in Nigeria, like other developing of countries of the world are entrapped by short-term placebo effects of many psychoactive substances provide but the potential colossal dangers inherent in such behaviours are overwhelming. In the year 2000, National Drug Laws Enforcement Agency (NDLEA) collected substance abuse data from schools, records of patients from National Neuro-psychiatric Hospitals in the country and those interviewed from persons arrested for drug-related offences. The results showed that secondary school students constituted the high risk groups for substance abuse. Friends and school mates accounted for about 90 per cent of sources of influence on the use and abuse of psychoactive drug/substances.
Secondary school students typically range from eleven years to about eighteen years in an ideal situation. There may be ranges beyond this age bracket. Nigerian secondary education system comprises two major strata, namely: junior secondary school and senior secondary school. Each stratum consists of three classes, junior secondary school one to three (JSS1- JSS 3) for lower stratum and senior secondary school one to three (SS1-SS3) for upper stratum. The later group of students is usually full of youthful exuberance. They are under peer influence. As member of peer group, they are prone to experimental use or social use of drug, which often leads to abuse (Keane, Reaper-Reynolds, Williams, & Wolfe, 2006; EMCDDA, 2012). Secondary school students could be boarders or day students, wherever the school environment is surrounded by markets, pharmaceutical stores, patent medicine stores, there is always a tendency for drug abuse (Oshodi, Aina, & Onajole, 2010).
Oboegbulem (2011) classified secondary school students into two groups based on age. Students in junior secondary school students fall within the age bracket 12-15 years while senior secondary schools students fall within the age bracket 15-18 years. Ogbuji (2003) also classified secondary school students into two groups based on age, namely, the junior secondary school students (12-14 years) and the senior secondary school students (15-17years). In the context of this study, secondary school students are individuals that fall within the age range of 12-18 years and accessing secondary education at different schools in Bauchi Education Zone. This study will assist in revealing the vivid picture of substance abuse patterns among secondary school students in Bauchi Educational Zone, Bauchi State.
Bauchi is the capital city of Bauchi State, presently the headquarters of Bauchi Local Government Area and the Administrative Headquarters of Bauchi Educational Zone. It lies between latitude 9.3o and 12.3o north of the Equator and Longitude 8.5o and 11o East of the Greenwich meridian. It is bordered by seven states namely Kano and Jigawa to the North, Taraba and Plateau State to the South, Gombe and Yobe to the East and Kaduna to the West. It occupies a total land area of 549,259.01 sq km representing about 5.3 percent of the land mass of Nigeria. Bauchi state has twenty Local Government Areas, three senatorial zones and three educational zones (Bauchi State Historical Perspectives, 2006). Bauchi Educational Zone has twenty six government approved secondary schools, fourteen of them in the urban areas and twelve in the rural areas.
Only public secondary schools were utilized in this study. This is because literature (Ogbuji, 2003; Oshodi, Aina, & Onajole, 2010; Oboegbulem, 2011) reveals that substance abuse is more prevalent among students of government-owned/public institutions including secondary schools and that many private schools are relatively new and the administrative bodies of these private schools eschew substance abuse based on religious faith, principles and enforcement of stringent rules when such principles are breached or circumvented. The study of both Federal Government’s and State Government’s secondary schools would expectedly reveal the vivid picture of patterns of substance abuse among Bauchi Education Zone, Bauchi State.
Dearth of established institutional and administrative structures to oversee drug-related cases such as misuse and abuse in Bauchi State also poses a threat to collection and analysis of valid data on substance abuse patterns to facilitate eradication or reduction of its prevalence and escalating trend among adolescents. The public health campaign unit of the State Ministry of Health on substance abuse is not well organized because of resource constraints. Therefore, the escalating trend in abuse of substances or drugs by students has become one of the most disturbing social health problems in Nigeria (NDLEA, 2007). Several in-school adolescents experience mental health problems, either temporarily or for a long period of time. Some become insane, maladjusted to school situation and eventually drop out of school. Therefore, there is an urgent need to investigate substance abuse patterns in order to proffer suitable and sustainable remedies among secondary school students in Bauchi Education Zone. Proffering possible solutions to substance abuse patterns and its attendant consequences among secondary school students will be significantly undermined without conducting the investigation within the framework provided by empirically established health behaviour theories.
This study was anchored on three theories. These are the Gateway theory (GWT), Reinforcement theory (RFT) and Socio-cultural theory (SCT).The gateway theory propounded by Chen, Kandel and Yamaguchi (1992) describes patterns of substance abuse by pointed out that there is a developmental process in which students become initiated into substance abuse through a sequence of stages with each prior substance abuse stage acting as a potential gateway to the former stage. The theory emphasizes the importance of prevention efforts aimed at curbing the transition to regular use of alcohol and cigarettes as well as their initial use.
The Reinforcement theory has its focus on the relationship of positive and negative motivations on substance abuse. The proponents of this theory are Alfred and Lineshmitt (1949 and 1968). This theory maintains that repeated abuse of substances by students are attributed to their pleasurable effects (Bajerot, 1980) and thus what is pleasurable tend to be repeated. Addicted students seek substances by all means to avoid consequences of withdrawal syndrome, thereby craving for drugs in different patterns to relief painful agony associated withdrawal of such substances. The Socio-cultural theory (SCT) shows how culture impacts on substance abuse behaviour of an individual student. SCT maintains that patterns of substances that are mostly abused among students are determined by the socio-cultural values of the societies they exist.
In recognition of the devastating impact of substance abuse on human populations, most countries, particularly developing countries are facing unprecedented social and health problems among its populations. The United Nations Convention on Narcotic Drugs and Psychotropic substances of 1988 also gave impetus to the fight against use of illicit drugs (UNODC, 2007). A major step taken by the Federal Government of Nigeria in line with this global realization was the establishment of the National Drug Law Enforcement Agency (NDLEA) via decree 48 of 1989 now known as Act CAP N30 LFN 2004 (as amended) was created by the former Head of State General Ibrahim Badamasi Babangida. The agency is saddled with wide responsibilities and powers of coordinating all illicit drug activities in the country. As laudable as this measure against substance abuse, it appears to be a widespread phenomenon that transcends socio-economic, cultural, religious and ethnic boundaries in Nigeria. This phenomenon is assuming an alarming proportion even among students in Nigerian secondary schools including students in Bauchi Education Zone, where, despite the efforts of the government to curb substance abuse through such agencies as NDLEA and NOA, it still persists along with its attendant problems (Shokunbi, 2000; Ajala, 2010; Oshodi, Aina, & Onajole, 2010). The investigation of substance abuse patterns among secondary school students in Bauchi Education Zone to a large extent was expected to provide profound insight into possible eradication of this social health problem.
Statement of the Problem
A public health approach to substance control takes into account that people use substances for anticipated beneficial effects, and that population-wide benefits may exist. When substances are used according to recommended medical/health prescriptions, beneficial effects of different substances include: physical (pain relief, assistance with sleep, potential decreased risk of cardiovascular disease, increased endurance, stimulation or diminution of appetite), psychological (relaxation, relief of stress and anxiety, increase alertness, assistance in coping with daily life, mood alteration, pleasure, performance, or creativity enhancement), social ( facilitation of social interaction, religious, spiritual or ceremonial use) and economic (wealth and job creation, industrial activity, employment, agricultural development, tax revenue generation). These benefits also accrue to secondary school students when substances are used according to recommended medical/health prescriptions but persistent consumption of substances and other psychoactive drugs in a maladaptive pattern and without recourse to medical prescription breeds grievous health, social, psychological and academic consequences.
It is well entrenched in literature that adolescents indulge in substance abuse but the places and time when they perpetrate substance abuse remains obscure. This prevailing situation among secondary school students transcends cultural or ethnic boundaries in Nigeria including Bauchi Education Zone, Bauchi State. If this trend is not identified and possible solutions proffered towards its eradication, the over health of secondary school students in BEZ may be jeopardize.
Thus, this encapsulates one of the focal points of this study. Also, influences of some demographic factors such as age, gender, location and other cohorts of substance abuse patterns among adolescents have been entrenched in several studies. This study, therefore, seeks to establish the influence of variables such as age, gender and class on substance abuse patterns among secondary school students in Bauchi Education Zone. The results may be used in identification of predisposing factors, designing and applying organized, appropriate programmes to discover prevailing substance abuse patterns among secondary school students which in turn may facilitate eradication of substance abuse among them. Hence, this study aims to bridge these gaps.
Purpose of the Study
The purpose of the study was to determine the patterns of substance abuse among the secondary schools students in Bauchi Educational Zone (BEZ), Bauchi State. Specifically the study aimed to:
1. find out the categories of substances commonly abused by secondary schools students in Bauchi Educational Zone;
2. identify factors that predispose secondary schools students to substance abuse in Bauchi Educational Zone;
3. establish the temporal patterns of substances abuse among secondary schools students in Bauchi Educational Zone;
4. ascertain the spatial patterns of substances abuse among secondary schools students in Bauchi Educational Zone;
5. identify the influence of age on patterns of substance abuse among secondary schools students in Bauchi Educational Zone;
6. establish the influence of gender on patterns of substance abuse among secondary schools students in Bauchi Educational Zone, and
7. determine the influence of class on patterns of substance abuse among secondary schools students in Bauchi Educational Zone.
The following research questions were posed to guide the study.
1. What are the categories of substances commonly abused by secondary school students in Bauchi Educational Zone?
2. What factors predispose secondary school students to substance abuse in Bauchi Educational Zone?
3. What are the spatial patterns of substances abuse among secondary school students in Bauchi Educational Zone?
4. What are the temporal patterns of substances abuse among secondary school students in Bauchi Educational Zone?
5. What are the patterns of substance abuse among secondary schools students in Bauchi Educational Zone according to age?
6. What are the patterns of substance abuse among secondary schools students in Bauchi Educational Zone according to gender?
7. What are the patterns of substance abuse among secondary schools students in Bauchi Educational Zone to class of study?
The following null hypotheses were postulated to guide the study and were tested at .05 level of significance.
1. There is no significant difference in the temporal pattern of substance abuse among secondary school students according to age.
2. There is no significant difference in the spatial pattern of substance abuse among secondary school students according to age.
3. There is no significant difference in the temporal pattern of substance abuse among secondary school students in Bauchi Educational Zone based on gender.
4. There is no significant difference in the spatial pattern of substance abuse among secondary school students in Bauchi Educational Zone based on gender.
5. There is no significant difference in the temporal pattern of substance abuse among secondary school students according to class of study.
6. There is no significant difference in spatial pattern of substance abuse among secondary school students according to class of study.
Significance of the Study
The study of this nature will be useful in several ways. The findings of this study may be of immense values and benefits not only to students but also to drug agencies like National Drug Law Enforcement Agency (NDLEA), National Agency for Food and Drug Administration and Control (NAFDAC), National Orientation Agency (NOA), Federal Ministry of Health (FMOH), Federal Ministry of Education (FMOE), Social Welfare Unit (SWU). Others are Health Educators, Counselors, Teachers, Parents and Policy makers, who will precisely assist the Ministry of Health, Ministry of Education, Curriculum Planners in formulating suitable and sustainable policies to prevent different patterns of substances abuse among the secondary schools students in Bauchi State in particular and in the whole country in general.
The findings of the study on common classes or categories of substances abuse will assist NDLEA, NAFDAC; Federal ministries of Health, Education to get more information on the common types of substances abuse that are prevalence among secondary school students and developing how strict the enforcement of the regulations concerning drugs would be on the students. National Agency for Food and Drug Administration and Control will develop various strategies to achieve regulations on substances abuse which could be through regular patrols and visits to the likely flash points of these substances abuse areas. The ministry of health will on the other hand make available genuine drugs in treating and rehabilitating victims of substances abused students.
The findings on demographic variation concerning substances abuse which include age, gender and level of education will be useful to the National Orientation Agency (NOA) as an agency responsible in providing information to the citizens. National Orientation Agency will also use the findings to develop the strategies for mass orientation of the citizens in order to have drug free and responsible citizens. The findings shall also be used by NOA to know the actual age, sex, level of education of persons that are involved in abusing various types of drugs with a view of helping the victims. The findings can also be used for mass enlightenment of the students and general populace especially at workshops, seminars and conferences on the implications of substances abuse to human existence.
Furthermore, the findings on temporal variations on times in which students abused drugs would be useful to the social Welfare Units (SWU) and NDLEA. For example, the SWU will use the findings to establish the actual periods that students involved in substances abuse and plan on how best to tackle such problems towards the betterment of the society. The NDLEA on the other hand would use the findings to establish when to set up strategic planning concerning substances abuse on students. The SWU would also use the findings of this study to achieve its objectives through the use of the provisions of appropriate rehabilitative units in their custody, which will involve the provision of appropriate drugs, food, talks from the clergies and imams among others in the rehabilitation units.
On the findings concerning spatial variations, which will be restricted to rural and urban locations of drugs abuse, findings will be useful to the SWU, NDLEA and curriculum planners. For example, the SWU will use the findings to establish the actual status of location of schools on students’ substance abuse and design plans towards having drug free community. The NDLEA, on the other hand will use the findings to strategize on which area locations requires what sort of attention and vigilance concerning drugs abuse. Substance abuse findings concerning students of rural and urban areas would be useful to curriculum planners. The findings would be useful to the curriculum planners as they would use such findings to establish what aspect of drug education would be stressed while planning the school’s curriculum of students of rural or urban areas. The curriculum planners would benefit from the findings of the study as it would serve as the means to evaluate the success or failures of the earlier planned curriculum concerning commonly abused substances.
The findings generated on the factors responsible for substances abuse among these secondary schools students. The information got on the factors for which students take psychoactive drugs will help both teachers and parents to tackle the problems of substances abuse from the grass root. The counselors will utilize the results to counsel students that have been addicted through many counseling techniques. Health Educators will organize seminars, workshops and conferences on the dangers of drug addiction. The result of the study will assist curriculum designers and reviewers in the specific area to include in drug education as an aspect of health education. Data that will be generated from the study will also serve as source materials to understand drug usage among secondary schools students.
Finally, this study is also significant in the sense that theories play an important role in Health Education studies (Rosen stock, 1997; Akinsola, 2006) also argued that theories and models are among the most useful tools utilized by health educators in the course of tackling challenges of health problems. Some theories such as Biological theory (BTD), Reinforcement theory (RIT), Socio-cultural theory (SCT) and Gateway theory (GWT) which have been developed to investigate patterns of drug abuse among different populations. These theories will be reviewed and if there are correspondence between any of the stated theories and anticipated findings of the present study, such a theory will be incorporated and adopted as an operational model in this study.
Scope of the Study
This study was carried out in Bauchi State. This study was delimited to patterns of substance abuse among the secondary schools students in all government and private owned secondary schools in Bauchi Educational Zone. These schools have homogenous regulations governing them. In addition, their curriculums are similar whether for exclusively boys or girls’ schools and co-educational schools. Specifically, the study also focused on the three components of patterns- spatial (places where the abuses occur), temporal (the time the abuses occur), demographic (including gender, age, location, and level of education). The study was further delimited to concept of substance abuse, patterns, students, commonly abuse classes or categories of substances abuse by students, factors that predispose secondary school students to substances abuse and the implications of these abused substances on their health.
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