Drug use among young people in Lagos, Nigeria

Sections

ABSTRACT
Introduction
Findings
Concluding remarks

Details

Author: Amechi ANUMONYE
Pages: 39 to 45
Creation Date: 1980/01/01

Drug use among young people in Lagos, Nigeria

Amechi ANUMONYE Professor and Head, Department of Psychiatry, College of Medicine of the University of Lagos, Lagos, Nigeria

ABSTRACT

This paper presents the results of two studies on drug abuse carried out among young people. One study included a sample of 2,846 pupils from 17 secondary schools in Lagos, the other 300 patients admitted to the Lagos University Teaching Hospital for treatment of drug abuse. Among the secondary school students the major substances used were alcohol, barbiturates, central nervous system stimulants, tobacco, Mandrax and cannabis. The majority of hospital patients treated for drug abuse were cannabis users.

Introduction

There is in Nigeria today very little information about youth drug use. There are some reports on adult drug abuse (Egwu, 1953; Lambo, 1961, 1964, 1965; Asuni, 1964; Boroffka, 1966; Anumonye, 1973; Oshodi, 1973; Oviasu, 1976) but few ongoing studies. This paper presents data on patterns of drug use among youth in the capital city of Nigeria and some of the factors associated with such use.

The drug-related problem in Nigeria

The official channels of distribution of drugs take the following forms in Nigeria:

  1. The indiscriminate sale of pharmaceuticals by pharmacists and medicine shop owners and vendors. In certain markets in Nigeria it is possible to obtain almost any type of drug;

  2. The indiscriminate prescription of pharmaceuticals by medical doctors in private clinics and hospitals. The easy availability of samples from sales representatives adds to the problem.

In addition, the major sources of illicit drugs appear to be:

  1. Smuggling from foreign territories

  2. Thefts from customs warehouses and commercial depots

  3. Trafficking by unscrupulous dealers

  4. Local cultivation of Indian hemp

Substances of abuse

Amphetamines are used among students and long-distance drivers in order to keep awake. They have also been used to combat hunger by people displaced during a drought (Oshodi, 1973). Barbiturates are used by persons with suicidal tendencies rather than for addictive purposes (Anumonye, 1975). Mandrax abuse once reached epidemic proportions among students (Anumonye, 1973). However, cannabis appears to be the main drug of abuse in Nigeria. The abuse of LSD is relatively uncommon although it has created an important problem for East African children. Opiates and cocaine are not readily available to young people, with the exception of pethidine which is occasionally abused, especially by the medical profession. Alcohol abuse has not yet received sufficient public attention, though it is on the increase and may become a greater problem within the next few years. This is primarily due to new attitudes towards the use of alcohol, including the recently lifted prohibition of illicit, locally made gin. In addition, there has been a proliferation of breweries with nearly all states in Nigeria brewing their own "state" brand of beer. However, indigenous palm wine (latex from palm trees) is gradually disappearing from the cities.

Subjects and methods

The results of two studies of young people are analysed and interpreted in this paper, a survey of pupils in 17 secondary schools in Lagos, and a study of patients admitted to the Lagos University Teaching Hospital for treatment of drug abuse.

In the survey of secondary schools, a modified version of the questionnaire developed at the Addiction Research Foundation of Toronto, Canada, was used. The questionnaires were distributed in the classrooms of the schools and the responses collected after one hour. This study of secondary schools took place over three months in 1973 and was later analysed in 1974.

The hospital study, which covered 300 patients, lasted one year and included persons who were treated both on an in-patient and on an out-patient basis. A questionnaire similar to that developed by Soueif (1967) for cannabis users was used. Each subject in this study was interviewed by a trained professional.

Findings

Survey of secondary school pupils

In 17 secondary schools in Lagos, 2,846 pupils responded to the questionnaire. They were mostly between 11 and 20 years of age and the number of male and female pupils in the sample was almost the same. The distribution by sex and age is presented in table 1.

Table 1

Distribution of the student sample by age and sex (N = 2,846)

 

Male

Female

Both sexes

Age in years

Number

Fraction of total (%)

Number

Fraction of total (%)

Number

Fraction of N (%)

11 60 4.3 41 2.9 101 3.5
12 156 11.1 123 8.5 279 9.8
13 250 17.8 233 16.1 483 17.0
14 267 19.0 334 23.1 601 21.1
15 295 21.0 343 23.8 638 22.4
16 154 11.0 191 13.2 345 12.1
17 102 7.3 93 6.3 195 6.9
18 50 3.6 36 2.5 86 3.0
19 17 1.2 12 0.8 29 1.0
20 4 0.3 1 0.1 5 0.2
>20
48 3.4 36 2.5 84 3.0
Total
1403 100 1443 100 2846 100

The use by substance is shown in table 2. Some students reported multiple drug use, e.g., Mandrax and alcohol, stimulants and barbiturates, cannabis and alcohol.

Table 2

Student drug use by substance

 

Male Users

Female users

Both sexes

Substance

Number

Fraction of male students (%)

Number

Fraction of female students (%)

Number

Fraction of N (%)

Alcohol
290 20.7 304 21.1 594 20.9
Cannabis
41 2.9 30 2.1 71 2.5
Mandrax a
57 4.1 36 2.5 93 3.3
Amphetamines
52 3.7 32 2.2 84 3.0
Barbiturates
158 11.3 299 20.7 457 16.1
Other stimulants
75 5.3 86 6.0 161 5.7
Tobacco
80 5.7 31 2.1 111 3.9

Note: Type of use is use "ever".

aMethaqualone and diphenhydramine.

Study of hospital patients

Of the 300 male patients of the Lagos University Teaching Hospital who had been included in this study, the majority (78 per cent) were using cannabis.

The age distribution of these patients at the time of first use of drugs revealed that more than 80 per cent of them started using drugs in the 14 to 16 age group and the majority (more than 70 per cent) made first hospital contact in the 15 to 18 age group.

As cannabis was the predominant illicit drug used in this group, the data have been analysed and interpreted for cannabis users only.

Although it is obvious that hospital patients, being a highly selected population, do not represent any natural population group in a community, the analysis of data obtained does throw some light on the problems associated with cannabis use.

Problems associated with cannabis use

Data on 234 cannabis users among the hospital patients were analysed separately according to physical, psychological, psycho-social and behavioural variables; the frequency of disorders is presented in tables 3,4,5 and 6.

Table 3

Physical disorders found among patients treated for cannabis abuse (N = 234)

Disorder

Fraction of N (%)

Reddening of conjunctiva
100
Increased heart rate
75
Irritant cough
20
Increased appetite
45
Sleeplessness
55

Table 4

Psychological disorders found among patients treated for cannabis abuse (N = 234)

Disorder

Fraction of N (%)

Distortion of hearing
90
Distortion of vision
72
Distortion of time
86
Dream-like thinking
45
False assessment of clarity of thought
60
Impaired psycho-motor co-ordination
65
(clumsiness in movement)
 
Illusions
63
Hallucinations
45
Delusions
72

Table 5

Psycho-social tendencies found among patients treated fo cannabis abuse (N = 234)

Tendency

Fraction of N (%)

To form groups with distinctive codes of behaviour
80
To have had severe behavioural disorders in early childhood
90
To exhibit emotional instability requiring psychiatric help
46
To fail to maintain balanced and co-ordinated behaviour
40
To display disinhibitive behaviour
57

Table 6

Deviant behaviour found among patients treated for cannabis abuse (N = 234)

Behaviour

Fraction of N (%)

Social disorganization
60
Educational failure
40
Occupational failure
53
Destructive acts against society
65
Criminal acts and minor misdemeanours requiring police action
30
Verbal or physical attacks of the family
62
Inability to benefit from previous experience
40
Emotional or behavioural deficiency
52
Absenteeism
56
Minor thefts
73

The major problems associated with cannabis use which led the patients to treatment were the release of innate mental disturbance, temporary toxic psychoses and the replacement of passivity by aggressiveness. The psychiatric disorders were similar to those observed by Lambo (1964) and Boroffka (1966) in adults who used cannabis. The most severe disorders were schizophrenia and schizophrenia-like or affective psychosis. The role of cannabis in these disorders is as yet unclear. Clinical study revealed certain characteristic features:

  1. The disturbances were more common among children above the age of 14 years;

  2. The symptoms were very pronounced and were associated with ideas and feeling of persecution and oppression, as well as with other perceptual disorders;

  3. The disturbances often included restlessness, agitation and sleeplessness;

  4. The rate of psychoneurotic disorders was considerably high. Psychoneurotic disorders were characterized by predominantly hysterical symptoms. The neurotic person needed considerable psychotherapeutic support and the rate of relapse was high.

Contributing factors

No single factor could be defined as solely responsible for the abuse of drugs although the following factors were frequently found among both Nigerians and other nationalities:

  1. Defective personality, including chronic inadequacy, poor frustration tolerance, insensitivity and egocentricity

  2. Widespread belief in the magic of medicines

  3. Enjoyment of induced euphoria and excitement

  4. Search for sharpened perception, especially by music lovers

  5. Dissatisfaction and disillusionment of young persons

  6. Self-medication of primary psychological disorders

  7. Lack of alternatives for various cultural changes

The following factors were associated with cannabis abuse:

  1. Predisposition to psychological disorders

  2. Poverty, parental deprivation and other forms of societal disintegration Peer group pressure

  3. Availability of the drug (cannabis)

  4. Social isolation in urban areas

  5. Early childhood disturbance

  6. Unrealistic planning

  7. Emotional instability

In addition, the transitional periods in education in the 11 to 12 and 15 to 16 age groups are of particular importance in the Nigerian culture. These are periods when Nigerian children change from primary to secondary and from secondary to post-secondary school systems. In these periods anxiety is commonly observed often associated with success in the entrance examinations and high parental expectation.

It is therefore clear that other factors, apart from those possibly caused by cannabis, may be very important in generating social and psychological disorders among cannabis users.

Concluding remarks

The Nigerian community has accepted the principle that abuse of drugs and alcohol is an undesirable feature of its culture. It is also important to emphasize the fact that many of the Nigerian youths come from different types of homes and that the cannabis use problem is not restricted to any one social class. Professions need to be more concerned about the use and misuse of drugs. The primary concern of all workers who deal with drug abuse should not be the substance abused but the persons abusing it and their reasons for doing so. In view of the fact that the person who abuses drugs is in unlawful possession, as well as involved in the sale, purchase or illegal diversion, of the drug for personal use, drug abuse is often viewed as both a crime and an illness, which complicates the treatment. In the setting of the Lagos