The non-medical use of prescription drugs

INTRODUCTION

Background to the Study

The non-medical use of prescription drugs is becoming a major threat to public health and law enforcement worldwide, with opioids causing the most harm and accounting for 76% of deaths where drug use disorders were implicated. According to the united nations on drugs and crime (UNODC, 2018), Tramadol – an opioid used to treat moderate and moderate-to-severe pain – has become a growing concern in Africa.

A survey carried out in Nigeria revealed that one in seven persons aged 15 to 64 years has experimented with a drug (other than tobacco and alcohol) in recent years. The adolescents are among the high-risk drug users, and they are reported to have problems such as missing school, doing poorly at work and at school, etc.

In many colleges, the student who has not experimented with at least drug is an exception. However, no longer is drug taking confined to colleges. It is advancing like forest-fire into secondary schools (Awake, 1999). Among care leavers aged between 14 and 24 years, drug abuse is much higher than in the general population, with three quarters of the population having at some point abused drugs (ward, 2003).

The most robust evidence highlights peer drug use, availability of drugs, mass media influence and also elements of family interaction, including parental discipline and family cohesion, as significant risk factors of drug abuse (Frischer, 2005). In particular, traumatic family experiences such as childhood neglect, homelessness or abuse increase the likelihood that an individual will develop problems with drugs later in life (Kumfer and Bluth, 2004)

Drug abuse refers to the use of certain chemicals for the purpose of creating pleasurable effect. Obioha (2004) and Jacob (2012) identified adolescents and young adults as constituting the high-risk group of people that use drugs. It is worthy of note that secondary school students mostly fall under these groups.

According to Jacob (2012), drug abuse is associated with various manifestations of failure to adapt, suicide, crime, delinquency, violence and rejection of all integration into school life by secondary school students. Nevertheless, if students are equipped with adequate knowledge of the risks associated with drug misuse and abuse, their engagement in the habit could be curbed so that they can live a qualitative life.

                                                             Statement of the Problem

Drug abuse is a problem that is causing serious concern to both individuals and government all over the world. The problem is prevalent among adolescents who in most cases are ignorant about the dangers inherent in drug abuse (Fareo, 2012)

The purpose for which drugs are used vary and the effects depend on the type and pharmacological composition. Drugs have both positive and negative effects. The positive effects could be seen in its relief of pains and treatment of infections. However, the negative effects come as a result of abuse. Its disagreeable and antisocial behavior leads to problems such as tearing into pieces human societies, spawning of crime, spreading of diseases like HIV and AIDS, and killing the adolescents and their future.

Psychoactive drug use may be considered as a continuous rising problem among adolescents in Nigeria. The most severe impact had manifested on the entire productivity and economy of the nation (Jacob, 2012). Health problems associated with drugs are as a result of non-medical prescription and use of drugs by majority of individuals. Such problems are related to drug abuse and misuse.

Iferi (2007) in Okafor (2009) highlighted the effects of drug abuse and misuse by students as the cause of maladjusted behavior like fighting, rebellion and other traits of juvenile delinquency. A major consequence of illicit drug misuse and abuse by adolescents is the perpetuation of criminal activities. In the light of the above point, the researcher set out to assess the knowledge and perception of drug use and abuse among secondary school students in Itu Local Government Area of Akwa Ibom State.

                                                        Purpose of the Study

The main purpose of the study was to assess the knowledge and perception of drug use and misuse among secondary school students In Itu Local Government Area of Akwa Ibom State. Specifically, the research sought to identify the most commonly abused substances and the factors that contribute to the abuse of those substances. It also intended to find out the knowledge of health risks and other implications of drug use among secondary school students in Itu local government area of Akwa Ibom state.

                                                       Objectives of the Study

  1. To determine the knowledge level of students about the implications of drug use and abuse.
  2. To assess the rationale behind the use and abuse of drugs among secondary school students.
  3. To provide information about the effects of drug misuse and abuse to secondary school students.

 

 

                                                          Research Questions

The following research questions were generated for the purpose of guiding the study;

  1. How do availability and accessibility to drugs influence its use and abuse among secondary school students in Itu local government area?
  2. Do the mass media influence the use and abuse of drugs among secondary school students in Itu local government area?
  3. How does parental background influence the knowledge and perception of drug use and abuse among secondary school students of itu local government area?
  4. How does the peer group influence the knowledge and perception of drug use and abuse among secondary school students in itu local government area?

                                                          Research Hypotheses

  1. There is no significant relationship between availability and accessibility of drugs and the knowledge and perception of drug use and abuse among secondary school students in Itu local government area.
  2. There is no significant difference between parental background and the knowledge and perception of drug use and misuse among secondary school students in Itu local government area.
  3. There is no significant difference between the mass media and the students’ knowledge and perception of drug use and abuse in Itu local government area.
  4. There is no significant difference between peer group influence and the knowledge and perception of drug use and abuse among secondary school students in itu local government area.

                                                        Significance of the Study

  1. It is expected that this study will provide necessary information and create awareness on the extent of drug use among students. This will help teachers, parents and other stakeholders to plan intervention programme that will help solve the problem of drug abuse in the society.
  2. It also expected to educate students on the implications of drug abuse and thus prompt them to make informed decisions on drug use.

                                                       Scope of the Study

The study is delimited to selected secondary schools in Itu local government area of Akwa Ibom state. It is further delimited to Senior Secondary two (SS2) classes.

                                                      Operational Definition of Terms

Knowledge, Perception, Drug, Drug Abuse and Drug Misuse

Knowledge: a state of knowing about a particular fact or situation.

Perception: a belief or opinion held by people about something or a concept based on how it seems.

Drug: any chemical substance which when taken causes an alteration in an organism physiology or psychology.

Drug abuse: the use of drugs to the extent that it interferes with the health and social function of an individual (Abdulahi, 2009).

Drug misuse: the use of drugs for purposes not consistent with legal or medical guidelines. Drug is abused when a prescription drug is used for a purpose other than its intended purpose.

 

LITERATURE REVIEW   

Theoretical Framework 

A theory, as defined by Okoro (2010), is a proposition or sets of propositions which intend to provide explanation for some class of observable events. It can also be defined as an attempt at synthesizing and integrating empirical data for maximum classification and unification. According to Okafor (2009), a theory synthesizes isolated bits of empirical data into a broader conceptual scheme of wider applicability, hence acting as a guide to fact discovery.

Theoretical framework refers to the structure that can hold or support a theory of a research study. The theoretical framework introduces and describes the theory that explains why the research problem under study exists.

For the purpose of this study, the following theories are considered;

  1. Social learning theory
  2. Availability-proneness theory of illicit drug abuse.

 

  • Social Leaning Theory.

Albert Bandura (1977) is the Proponent of the social learning theory. The intention was to explain how individuals learn in a social environment by observing and imitating the behavior of others. In social learning theory, it is believed that learning is influenced, not just by reinforcement, but also by the presence of others.

Okafor (2009) ascertained that there are four conditions required for a person to successfully model the behavior of someone else;

  1. Attention
  2. Retention
  3. Reproduction (motor reproduction)

Attention: This is the behavioral and cognitive process of concentrating on a discrete aspect of information, whether subjective or objective, while ignoring other perceivable information.

Retention: Learning takes place when certain facts or information are internalized in the memory.

Motor reproduction: When learned facts are provided when required, motor reproduction has taken place (Wheeler, 2019).

Motivation: It generates from the observation of punishment inflicted or reward given to an individual for something done or said.

Social modeling is a very powerful method of education. If a positive consequence from a particular type of behavior is seen, there is a tendency for such behavior to be repeated. Conversely, if negative consequences are the result, such behavior is less likely to be repeated. Social modeling also plays the following roles:

  1. Increasing or decreasing the frequency of which previously learnt materials are repeated or carried out.
  2. Teach new behavior.

The implication of this theory is that there is a consistent and relatively strong association of adult drug use and abuse and teen drug abuse. For instance, a parent who abuses drug is more likely to raise young drug abusers than the one who does not.

 

                                                    Availability-Proneness Theory of Illicit Drug Abuse

Availability-Proneness Theory of Illicit Drug Abuse (Reginald G. Smart, 1980). The availability-proneness theory of drug abuse involves the proposition that drug abuse occurs when a prone individual is exposed to a high level of availability.

The concept of availability has several facets or meanings. It refers to the set of physical, social and economic circumstances surrounding the ease or difficulty of obtaining drugs, especially with respect to their cost or amount of physical effort required to obtain them. Availability may also refer to social aspects because drugs are more available in some social groups than in others. In some schools, drugs are used by many members. The availability of any drug, then, for a person new to this kind of environment is far greater than it would be in a school which does not countenance drug users.

Proneness to drug abuse is said to be of many types. Many studies have shown that drug abusers have numerous psychological problems before the addiction is developed. Those problems are said to include but not limited to impulsivity, low tolerance for frustration, depression, anxiety and alienation (Catton and Shain, 1976).

The two-factor theory (availability-proneness theory) has its strengths and weaknesses. Strengths of the theory are in its generating propositions that could be easily understood. It could also be applied to other social problems, such as criminality with some changes. On the other hand, its weaknesses include:

  1. The major concepts of availability and proneness are not very specific, but they are global terms with a variety of possible meanings.
  2. There is a physical analogy that could be made about the theory _ that of a hydraulic pump: where availability is high, proneness need not be and vice-versa.

The implication of this theory is that the school, home and wider society should play parts in reducing or preventing the availability of illicit drugs and its use.

                                                        Conceptual Framework

Concept means what is organized around a main idea or theme. In this study, the conceptual framework will be discussed under the following sub-themes;

  1. Concept of drug.
  2. Drug abuse.
  3. Drug misuse.
  4. Classification of drugs.
  5. Knowledge of drug use and abuse among secondary school students.
  6. Perception of drug use and abuse among secondary school students.
  7. Implications of drug abuse.

                                              Concept of Drug

A drug can be defined as chemical substance of a known structure, other than nutrient of essential dietary ingredient, which when administered to a living organism, produces a biologic effect.

A drug can also be defined as any chemical substance which when taken and absorbed into the body of a living organism, alters normal function (Welister, 2005).

A drug is any substance that causes a change in an organism’s physiology or psychology when consumed (Wikipedia, 2007).

According to Unah and Umoh (2004), a drug includes vegetable, animal or mineral origin, or any preparation or mixture thereof manufactured, sold or advertised for use in the diagnosis, treatment, mitigation or prevention of diseases, restoring, correcting or modifying organic functions.

                                                         Drug Abuse

Drug abuse is more of a social term than a scientific term. Drug abuse, also known as substance abuse, is the use of drugs for the purpose of creating pleasurable or unpleasurable effects on the brain. It is the use of adverse or negative pharmacological properties of drug for selfish, economic or psychological purposes.( Akiwande, 2004) It is a maladaptive pattern of substance use that is not considered dependent (Fields, 2004).

According to Jacob (2012), drug abuse is often associated with various manifestations of failure to adapt, suicide, delinquency, violence and rejection of all integration into school life among adolescents.

 

                                                         Drug Misuse

Drug misuse is a term often used interchangeably with drug abuse. However, there is a clear difference between the two. Drug misuse is when prescription drug is used for a purpose other than its intended purpose. Moreover, when a prescribed drug is used by a person other than the one for whom the drug was prescribed, it is drug misuse.

The World Health Organization (WHO, 2006) defines drug misuse as the use of a substance for a purpose not consistent with legal guidelines. It has a negative impact on health or functioning. Drug misuse is increasingly portrayed as a medical disorder, partly due to advances in the understanding of the neurobiology underlying dependence. (Volkow and Li, 2005)

                                                         Classification of Drugs

Drugs are classified under the following;

  1. Stimulants
  2. Depressants
  3. Hallucinogens
  4. Sedatives
  5. Narcotics

Stimulants: it is a term that covers many drugs including those that increase the activities of the central nervous system and the body, drugs that are pleasurable and invigorating (Oxford Dictionaries).

Stimulants have ergogenic effect; that is, drugs of this kind are believed to enhance performance. Drugs of this class are used by students to enhance their academic performance. An example of a stimulant often abused by students is caffeine. Caffeine is a stimulant compound found in coffee, cocoa and chocolate. Caffeine’s mechanism of action differs from many stimulants as it inhibits adenosine receptors. The adenosine receptors are thought to be a large driver of sleep and drowsiness, and their action increases with extended wakefulness (Bjorness and Greene, 2017). The popular drug used by students to initiate wakefulness is the Nescafe.

Depressants: a depressant is a drug that lowers neurotransmission levels, which is to reduce arousal or stimulation in various areas of the brain. Medically, depressants have been used to induce sleep and reduce anxiety. Among the most widely used depressants are alcohol, tranquilizers and barbiturates.

Hallucinogens: these are a class of drugs that cause profound distortion in an individual’s perception of reality, otherwise known as hallucinations (Buddy, 2019). While under the influence of hallucinogens, users might see images, hear sounds or feel sensations that seem to be real but are not.

According to Buddy (2019), scientists are not sure exactly how hallucinogens produce their effect on the user. However, classic hallucinogens are thought to affect neural circuits in the brain involving the neurotransmitter – serotonin. The area of the brain affected control mood, sensory perception, sleep, hunger, body temperature, sexual behavior and muscle control.

According to the American Addiction Center (2019), an estimated 1.2 million individuals over the age of 12 reported using hallucinogens for a variety of purposes, including religious, recreational, stress, relief, etc. These drugs although not considered to be classically addictive, can lead to severe consequences.

Tranquillizers: They are central nervous depressants that interact with brain activity causing deceleration. It leads to slurred speech, staggering gait, poor judgment, and slow, uncertain reflexes (Montenegro, Veiga, Deslandes, Cagy, McDowell, Pompeu, Piedade and Ribeiro, 2005).

Sedatives can be misused to produce an overly-calming effect (alcohol being the classic and the most common sedating drugs). In the event of overdose, they can cause unconsciousness or even death.

Sedatives are related to hypnotics but not similar. Hypnotics, commonly known as sleeping pills are a class of psychoactive drugs whose primary function is to induce sleep. Whereas the term sedative describes drugs whose main purpose is to initiate, sustain, or lengthen sleep (Brunton,Lazo Parker,2006).

Narcotics: Narcotics are called opioid pain relievers. When used carefully and under a health care provider’s direct care, these drugs can be effective at reducing pains. Common narcotics are; Codeine, Morphine, Tramadol, etc. These drugs can be abused. They have been associated with accidental overdose deaths. Drowsiness and impaired judgment often occur with these drugs.

According to Zwannger (2018), heroin is the most commonly abused narcotic. A drug called tramadol has been enlisted under illicit drugs in Nigeria, therefore, its purchase and usage is considered illegal.

  Knowledge and Perception of Drug Misuse and Abuse among Secondary School Students

Knowledge is the familiarity, awareness, or understanding of something or someone, such as facts, information descriptions or skills, which is acquired through experience by discovering or learning. Knowledge is a theoretical or practical understanding of a subject (Oxford Dictionary). Hornsby (2005) defines knowledge as the information, skills, and understanding that one gains through education. He further states that knowledge is the state of knowing about a particular fact or situation.

Perception, according to the dictionary is the belief or opinion often held by people and based on how things seem. Udo (2002) defines perception as the act of interpreting a stimulus already registered in the brain by one or more sense organisms. There exist an inter-relationship between knowledge and perception. Considering the definitions of knowledge and perception and linking those with drug abuse help in the understanding of the study.

Perception of drug use and abuse among secondary school students follows or comes as a result of what the students know about the concepts of drug use and abuse. It means that knowledge precedes perception.

Many students in secondary school tend to see the drug abuser as one who is tough, bold and strong. Many youngsters have been known to use drugs at the instance of peers, elders or siblings (Fareo, 2012). A number of factors influence the knowledge and perception of drug use and abuse among secondary school students. The factors include; the mass media, parental background, peer group influence, a viability and accessibility of drugs among others. Each of these factors is deliberated on in the course of this study.

  Influence of the Mass Media on the Knowledge and Perception of Drug Use and Abuse among Secondary School Students

According to the Encyclopaedia Britannica (2019), the mass media include the radio, television and the internet. They affirm the attitudes and perceptions that are already established.

Advanced technology has made it easier for humans to interact and communicate with each other. According to Dennehey (2005), internet has eased the transaction of drug selling. Sales of drugs on net increase exposure of drugs to non-users who may be tempted to later abuse the drugs. Undeniably, there are also websites advocating anti-drug messages by communicating the negative impacts of drug abuse and other related information. Unfortunately, by typing in the name of drugs on a search engine such as Google, those advocating drug abuse directly or indirectly are most likely to be retrieved (Wax, 2002).

Moreover, some television programs go a long way to publicize the effect of drug abuse on the overall well-being – socially, physically, emotionally and psychologically. However, some advertisements over this medium promote the abuse of drugs. This is also applicable to the radio.

                                                           Availability and Accessibility of Drugs

Availability of drugs is one of the factors contributing to the increasing drug abuse during recent years. According to the Bureau of Justice Statistics report in 2007, student in the junior secondary admitted that they had been offered, sold or given illegal drugs on the school property. When accessibility of drugs is easy, chances of people trying out and consequently being addicted to drugs is increased.

 

 

                                                           Peer Pressure

Peer group refers to a group of equals both in age and level of development. People who constitute this group are usually children or adolescents (Egbule, 2009). The peer group constitutes a powerful agent of socialization.

In many cases, children and teen tend to fit in. they behave and make decisions based on what they think their peers want them to do. A study conducted by the National Institute on Drug Abuse (2016) found that teens are more likely to act out risky behaviors if they know their peers are watching. On the other hand, when young people see that their peers are leading healthier and more joyful lives, it helps increase their motivation to do same. A recovery program that provides social functions a teen once received from fellow drug users makes the road to sobriety easier. While peer pressure can be an issue that leads to drug abuse, it can also be used to recover from it.

                                                           Implications of Drug Abuse

Drugs are chemicals that affect the body and brain. Different drugs can have different effects. Conversely, these effects can depend on how the drug is delivered. For example, the injection of drugs directly into the bloodstream has an immediate impact, while ingestion has a delayed effect. But all misused drugs affect the brain. They cause large amount of dopamine, a neurotransmitter that helps regulate our motivation and feelings of pleasure, to flood the brain and produce a ‘high’.

Eventually, drugs can change how the brain works and interfere with a person’s ability to make choices, leading to intense cravings and compulsive drug use.

 Effect of Drug Abuse on Health

Drug abuse has the following effects on the health of the abuser;

  1. A weakened immune system, increasing the risk of illness and infection;
  2. Heart condition ranging from abnormal heart rate to heart attacks;
  3. Nausea and abdominal pains;
  4. Increased strain on the liver, liver damage;
  5. Lung disease;
  6. Problems with memory, attention and decision making, which make daily living more difficult;
  7. The most severe health consequence of drug abuse is death;

 Effect of Drug Abuse on Behavior

The effects of drug abuse on behavior include;

  1. Aggressiveness.
  2. Hallucinations.
  • Impulsiveness.
  1. Loss of self-control.
  2. Impaired judgment.

These effects have consequences such as missed work, punishable offenses, accidents and injuries.

 Effects of Drug Abuse on Academic Performance

Common effects of drug abuse on the brain that impact academic performance include difficulty concentrating, inability to process information and problems with working memory.

                                                              Empirical Framework

                                                                   Empirical framework reflects on the past works that relate to drug abuse and misuse. Onohwosafe (2012) that drugs commonly abused by are those easily bought over the counter.

According to Okafor (2009), more than 40% of students involved in drug abuse and misuse came from broken homes. He said that the reason why these students got involved with drug abuse and misuse was that monitoring and firm supervision by parents were not in place. These young ones, in the quest for solace and attention, went to those in their peer-group and other adult who introduced them to smoking and use of other hard drugs. Okorodudu and Okorodudu (2004); and Enakpoya (2009) showed that secondary school students were very susceptible to the influence of their peers.

Drug taking is a behavior, a response emitted by or elicited from an organism (Okafor, 2009). As such, it follows the basic principle when it either increases an individual’s pleasure or reduces his discomfort. Recreation was another reason given as for drug abuse.

Odejide (2006) asserted that students used drugs to keep awake in order to read far into the night, especially during examination. He emphasized that students used drugs to ease tension, for enjoyment, curiosity, to avoid stage fright and meet up with daily problems.

A report from Adesua(2006) claimed that more than 95% of adolescents have not seen the need of consulting the doctor before taking any drugs.

Ubom (2004), in his research work, indicated that the problem of drug aybuse knows no boundaries or social class. It impedes the development of any society as it is a threat to life, health, dignity and prosperity.

Fayombo and Aremu (2000), in their research on the effect of drug abuse on the academic performance of some adolescent drug abusers, found that the misuse of marijuana had reached an epidemic level in the present Nigerian society, and that drug abuse could lead to reduced academic achievement or even halt one’s academic process.

Okparake and Bello (2012) pointed out the risk factors associated with the abuse and misuse of drugs among students to include academic failure and little commitment o school. Students who have poor academic performance are more likely to engage in drug abuse.

Jacob (2012) reported that the knowledge of the effect of psychoactive drug use can curb drug abuse to increase good health status of the students. Fareo (2012) recommended that, to help reduce drug abuse among adolescents, family education on drugs should be established. More so, effective curricula on drug education should be designed. Lastly, counseling centers for drug control should be established.

Summary of Literature Review

The chapter considered the theoretical framework, a review of two theories which have to do with drug abuse. The reviewed theories were; the Social Learning Theory, proponented the by Albert Bandura, and the Availability-Proneness Theory of Illicit Drug Abuse, by Reginald Smart. It also considered the theoretical framework under which concepts such as; drug, drug abuse, classification of drugs, etc. were discussed. Empirical framework reflected on the past work that relate to drug abuse and misuse.