Substance Abuse Among Adolescent Students

expression Ab economic consumption Among Adolescent StudentsCHAPTER I INTRODUCTION1.1. BackgroundAdolescence is a pointedness of transition from childhood into adulthood, a expiration of physical, psychological and loving maturation. This is a crucial rate of flow of life when an individual is no longer a child but not yet an adult. The terminal figure juvenile refers to individuals betwixt 10-19 historic period of come along ( earliest adolescence 10-14 years and late adolescence 15-19 years). In this period they ar usually very energetic, enthusiastic, and anxious and become much autonomous in their decision pickings.1 To show that they ar capable of handling themselves the encounter victorious behavior among them is very high which, as a consequence, may bring down different kinds of problems. core ab give is common and angiotensin-converting enzyme of the near pitiful problems among the y emergehs. In Nepal y bring outhfuls comprise ab surface virtuoso four th (24%) of the total population.2 spunk treat refers to the stabbing or hazardous use of psychoactive sums, including baccy, alcoholic drink and illegitimate medicines.3 tenderness abhorrence is the use of any bosom(s) for non-therapeutic purposes or use of medication for the purposes other than those for which it is prescribed. It refers to the over-indulgence in and dependence of a drug or other chemicals leading to effects that argon detrimental to the individuals physical and mental wellness, or the welf atomic number 18 of the others. Substance offense has entangled roots in biological predisposition, personal development, and societal context. Specific amicable correlates such as p bent-child conflict, child physical and sexual offense, family breakdown etc has overly great role4. The transition from adolescence to young adulthood is a crucial period in which experimentation with illicit drugs in many cases begins. Because of their innate remnant and thir st for new attends, peer pressures, their resistance to authority, some clocks low egoism and problems in establishing positive interpersonal relationships, young pot are curiously susceptible to the allure of drugs. Howalways, all youth around the world do not hand over the same reason for ab victimisation drugs.5 Substance abuse as well predicts affiliation with network of deviant peers who introduce these adolescents to other meats.4 2Adolescent essence use usually starts with alcohol and cigarette which are referred to as entrance tendernesss. They are the initial marrows use before others are tried out and later progress to more(prenominal) than than than dangerous adepts such as ganja and cocaine.4 In more or less societies cigarette gage, alcohol drinking and use drugs are more or less perceived by young people as something alluring. Many similarly see it as a condition symbol, a way to telling their peers and contemporaries that they have come of age. I n Nepal, alcohol use has not been interpreted seriously either by the community or by any social organization.6 in that respect is no age restriction on buying cigarettes. Cannabis and alcohol were traditionally employ in Nepal for centuries. A safe dealnabis derivative such as marijuana and bhang is often justified in connection with religious festivals because of the presumed expectancy by one principal figure of the Hindu pantheon, the lord shivah for the drug.7 With time, risky behavior such as gluing, sniffing and injecting the drugs has been introduced. Though drug use is strictly illegal in Nepal, the easy access and availability of drugs has created a conducive environment for the people to start taking such substances, oddly among young people and children. Substance abuse is one of the main risk factors for gets of heart and lung diseases, oral, lung and stomach cancer, psychiatric problems and even death. Poor social coping skills, broken homes, disturbed relations hips and risky behaviors is its social consequences.3 A number of measures, two on supply reduction and demand reduction, have been taken by the government and non-governmental organizations. However, the number of drug users is in the increasing trend.6 Substance abuse, thitherfore, is still a major public health problem and theres a need of more extensive awareness and rehabilitation programmes.1.2. Problem reportSubstance use poses a significant health, social and economic bane to families, communities and nations. The extent of worldwide psychoactive substance use, according to World wellness Organization (WHO) 2002, is estimated at 2 billion alcohol users, 1.3 billion so-and-sors and 185 zillion drug users. Similarly, there are 150 billion adolescent tobacco plant plant users. In an initial estimate of factors responsible for the global interference of disease, tobacco, alcohol and illicit drugs contributed together 12.4% of all deaths worldwide in the year 2000.8 3 to bacco plant alone contributes 8.8%, alcohol- 3.2% and illicit drugs-0.4% of all the death worldwide. Injecting drug use has been in produce in 136 countries, of which 93 countries report HIV infection among this population. Tobacco is the largest burden in Europe and South-East Asia maculation alcohol poses the largest burden in Africa, the Americas, and Western Pacific. Worldwide alcohol causes 2.5 million deaths (3.8 % of total) and 69.4 million (4.5% of total) of Disability-Adjusted Life years (DALYs).8 According to Nepal Demographic Health observe (NDHS) 2006, one-third of men mourning band cigarettes and two-fifth consumed other forms of tobacco, whereas 15% of women smoke cigarettes and 5% consumed other forms of tobacco.2 According to Non contagious Disease Risk Factors Survey 2008 in Nepal, 37.1% were tobacco users. Of them, 26.2% (35.5% men and 15.9% women) were prepare to be soon smoking among which 23.8% were daily smokers. Mean age of the mental hospital of smok ing was 18.8 years for men and 12.9 years for women. Similarly, 28.5% were found to be currently consuming alcoholic drinks wherein almost one and half times more men (39.3%) than the women counter parts (16.5%).9 The report published by join Nations Economic and Social Council (UNESC) showed that the younger the age of first use of illicit drugs, the higher the severity of drug problem later. The age of first experience with drugs has been falling in many regions of the world. Adolescent substance use is progressively prevalent throughout the world.10 According to the Nepal Adolescent and Young Adult (NAYA) Survey 2000, intimately one-quarter of the young boys and one in ten girls have see smoking.11 Study conducted in Nepal by Ministry of Health and Population (MOHP), New era and orc Macro, 2002 have revealed that 47.4% of the adolescents aged 15-19 has consumed alcohol. Study conducted among teenagers in seven districts of the country stated that more than one in ten teenag ers admitted to taking drugs. Of these teenagers, 56% took drugs by smoking, a quarter by inhaling (26%) and 5.4% admitted to injecting drugs.11 41.3. RationaleSubstance abuse has been a rising social, economic and public health problem and the hazards associated with it are undeniable. It is one of the forms of behavior most damaging to the health in the long term and is associated with other risky behavior such as engaging in unprotected sex which may result in HIV/AIDS.7 Adolescence period is the major age of basis of substance abuse.6 Substance abuse among adolescents seems to be alarmingly pace around the world and Nepal is no exception. Though there are organizations working for adolescents, very fewer studies are conducted regarding this issue. Awareness programs are insufficient due to the scarce of information of the real scenario. Since majority of substance abuse among youths starts in the develop, the school population is the best place for early detection and preventi on of substance abuse in the adolescent population. As a result of lack of sufficient and reliable data from which generalization can be derived for Nepal, there is a definite need for additional school surveys on substance abuse in the country. This study provides the standstill information on the use of various substances among school adolescents. It is intended to run along the magnitude of substance abuse among school children, the factor motivating them to abuse and knowledge and percept regarding substance abuse so that the possible interpolation could be taken.1.4. Objectives1.4.1. General objectiveTo find out the magnitude and associated factors of substance abuse among adolescent students in morselary schools of Vyas municipality, Tanahun. 51.4.2. Specific objectivesTo identify the preponderance of substance abuse among the adolescent students of Vyas municipality. To determine the age of initiation of substance abuse. To find out the factors influencing the initiatio n of substance abuse. To explore the students desire for chuck up the spongeting abuse of substance. To determine the students knowledge and perception regarding substance abuse. To determine patterns of substance abuse in terms of sex and type of school.1.5. Research questionsWhat is the prevalence of substance abuse among the adolescent students? What is the knowledge and perception of adolescents towards substance abuse? Do sex and type of school deflect the use of substance?1.6. Variables1.6.1. aquiline Substance abuse1.6.2. Independent Age wind up Peer influence Availability Types of school companionship and perception regarding substance abuse61.7. abstract frameworkAvailabilitySubstance abuse among school adolescentsAgeSexPlaceFamily HistoryType of schoolPeer influenceKnowledge and Perception regarding substance abuseTypes of substanceFigure 1 abstract framework1.8. Operational definitionsSubstance Any psychoactive material which when consumed affects the way people fe el, think, see, taste, smell, hear or behave. Cigarette, chewing tobacco, alcoholic products and drugs (drug tablets, cannabis, heroin, opium, glue/gum, tidigesic, tranquilizers) are included as a substance in this study. Substance abuse Substance abuse is the non-medical use of substances in order to achieve alterations in psychological functioning. Use of any of the substances mentioned above for two or more times in a lifetime is included under substance abuse. Adolescent students Secondary school students of grade 8, 9 10 of both(prenominal) community and institutional schools within the age of 10-19 years are considered adolescent students. School Government-aided community schools and institutional schools are studied. 7Knowledge level regarding harmful effects of substance abuse Those who could list at least one or more harmful effects of substance abuse are considered as having good knowledge and those who couldnt list any are regarded as having poor knowledge. Perception towards substance abuse The perception of the students was measured in 3 points scale agree, disagree and cant say. Statements for measuring perceptions are One who abuses substance has more friends. One who abuses substance has negative image in the society. It is difficult to quit the substance after getting into it.8CHAPTER II LITERATURE REVIEWSubstance abuse is rising public health as well as social problem throughout the world. It poses a significant threat to the health, social and economic foundation of families, communities and nations. It is one of the major preventable causes of death and disability. There are roughly 2 billion alcohol users, 1.3 billion smokers and 185 million drug users worldwide.8 Consumption of substances has increased all over the world and the age of initiation of substance abuse is progressively falling. There has been increase in social and economic factors which make young more vulnerable and presumable to engage in drug use and drug-related ris k-taking behavior.10 A study carried out on Socio-Demographic Correlates of Psychoactive Substance Abuse among Secondary School Students in Enugu, Nigeria showed that 33.7% of the adolescents were substance abusers. Alcohol was most commonly abused (31.6%). Prevalence of the cigarette smoking was 14.3%, inhalants 9%, tranquilizers 7.4% and cannabis 4.15%. Males consumed most psychoactive substances more oft than the fe manlys. Cigarette and cannabis were the exclusive preserve of the males. Older students were more winding in multiple substance use compared to younger ones. Among the users, 75% of the respondents were using more than one substance whereas 24.8% used only one substance.4 In a study carried out on Drug use among adolescents in Asturias (Spain) among the school students, 29.1% were drug user among which 55% were male. The average age of initiation of drugs was 15.4 years for males and 15.5 years for females. Cannabis was the most frequent drug used ever i.e. 20.8% of the total respondents became involved with this drug at sometime of their lives. Tranquilizers was second (10.3%), followed by amphetamine-like substance (7.9%) and inhalants (2.3%). The mean age at first drug use was 15.4 years for males and 15.5 years for females.12A study carried out on Licit and illicit substance use by adolescent students in eastern India Prevalence and associated risk factors among 416 students of classes VIII, IX and X in inelegant and urban settings gave the prevalence of 6.14% and 0.6%. The mean age of initiation of substance abuse was 12.6 and 13.9 years among rural and urban students respectively. Tobacco followed by alcohol was most commonly used in both setting. Prevalence was higher in males. Use of a substance by family 9members had a significant pertain on its use by their children. Enjoyment and Curiosity were found to have the major influence in their decision to use a substance.13 some other study carried out on Substance use among secondary s chool students in an urban setting in Nigeria prevalence and associated factors revealed that the life time use prevalence rates of alcohol and tobacco were 9.25 and 5.2%. The commonest substance used by the students was caffeine (85.7%). In terms of gender, the prevalence rate for male was higher than for their female counterparts except for antibiotics, analgesics, heroin and cocaine. Major Reason for using substances included relief from stress- 43.5%. About three quarters of the respondents (70%) were unaware of problems or complications that could arise from substance use while 10.5% believed poor physical health could arise.14 Department of Narcotic Control in Bangladesh, in June 2008, reported about 5 million drug addicts in the country among which young and adolescent population comprised 91%. Heroin is the most widely abused drug in Bangladesh.15 A study of adolescent smoking and drinking carried out among adolescent students in 2007 in Korea have shown that the prevalence of smoking was 29.2% while drinking was 48.2%. The mean age at the first instance of smoking and drinking was 13.8 and 14.1 years respectively. Among drinking adolescents, 30.1% were offered a drink by their parents, although most adolescents were encouraged to smoke or drink by their friends.16The Global offspring Tobacco Survey (GYTS) of school-going adolescents of class 8-10 conducted by WHO in the South-East Asia share revealed that one in 10 school-going adolescents in Nepal use some form of tobacco. The smoking rate for girls was significantly lower than that for boys. Exposure to smoke was both at home and in public places. Despite a unquestionable proportion of adolescents using tobacco, a large proportion of current smokers valued to stop smoking. Regular presence of smokers in the family and easy accessibility of tobacco products were the major contributing factors to the prevalence of the smoking habit among adolescents in Nepal. It was also observed that almost one i n ten smoking students smoke at home, revealing that there is no parental pressure on them to stop.11 10United Nations International Childrens Fund (UNICEF) 2001 survey in Nepal reported that more than one in ten teenagers admitted to taking drugs. Of these, 56% took drugs by smoking, 26% by inhaling and 5% by the injecting route. Majority (76.7%) of the adolescents was introduced to the drugs by their friends and 12% started taking on their own while 7% were encouraged by their induce and uncles.11 According to a study done in school students of rank 8, 9 and 10 in Pokhara sub- metropolitan city, nearly half 47.1% of the students ever used tobacco products. One in seven (13.2%) were current users, one in four (22.7%) were experimental users and one in ten were the bypast users of any tobacco product. The mean age of initiating tobacco was about 13 years and nearly one fifth (18.9%) initiated before 10 years of age. Boys were more liable(predicate) to use tobacco than girls and adolescents of institutional schools were more likely to use tobacco products as compared to community school students. Regarding the knowledge of students about tobacco use nearly one third (31%) of the adolescent students were having good knowledge and less than half (42.7%) were having some knowledge about the hazards of tobacco use. Significant proportions of the adolescents have wrong perceptions about the use of tobacco i.e.47% aspect that tobacco users have more friends and 27.3% thought that tobacco users are more attractive.17 11