CHAPTER FIVE

5.0 DISCUSSION

Introduction

This chapter sheds light on various aspects of drug abuse among youth in Sukuta. It aims to

knit together the different components of the research report, drawing connections between

the study's objectives, literature from the opening chapters, and the critical analysis of the

findings

5.1 Socio-demographic characteristics

This study surveyed 83 participants, of whom (n=73) 88.0% were male, and (n=10) 12.0%

were female. Such a significant gender disparity suggests potential differences in drug abuse

prevalence within the study population, with males being more prominently affected. The

observed gender disparity aligns with a systemic review on Peer Influence and Adolescent

Substance use by Henneberger et al., (2020) which revealed that 56.3% of the total sample

were males, indicating a higher prevalence of drug abuse among males. However, this

magnitude can vary across different populations and settings. Regarding age distribution, the

largest group consisted of individuals aged 20-24 years, comprising 38 participants (45.8%).

The 15-19 age group followed closely behind, with 27 participants (32.5%), and the 25-29

age group had 18 participants (21.7%). This distribution indicates that drug abuse might be

more prevalent among young adults, especially those in their early twenties. The

concentration of drug abuse among young adults, particularly those in their early twenties,

mirrors broader epidemiological trends, highlighting the vulnerability of this age group to

substance use disorders (DiGuiseppi et al., 2020). In terms of educational attainment, 46

participants (55.4%) had completed Senior Secondary School education, (n=23) 27.7% had

Junior Secondary School education, and (n=11) 13.3% had attained Tertiary level education.

While these findings suggest a potential link between lower educational levels and drug

abuse, the relationship is complex and may be influenced by various contextual factors (????)

. Further research is needed to explore this relationship comprehensively. Occupationally, the

majority of participants (45.8%) identified as self-employed, followed by those involved in

business (19.3%) and students (19.3%). These statistics underscore the importance of

considering occupational factors in understanding drug abuse patterns, as different

occupations may entail varying levels of stressors and social environments conducive to

substance abuse (Chan et al., 2017). While self-employment and certain occupations may

expose individuals to risk factors for substance abuse, employment can also serve as a

protective factor through the provision of structure and social support (Collins et al., 1998).

5.2 Most abused Drugs in sukuta.

The most abused drug substances within the study population include cocaine, tobacco,

marijuana/cannabis, kush and alcohol. The most prevalent combination reported by the

participants was Marijuana/Cannabis with Tobacco, comprising 27 (32.5%) of the total

respondents. Such widespread use underscores the importance of addressing the associated

risks and implementing targeted interventions. A study by Gravely et al., (2020) revealed

how this combination poses significant health risks, including synergistic effects amplifying

addictive potential, heightened respiratory health hazards due to exposure to harmful smoke

constituents, increased risk of nicotine and cannabis dependence, cognitive impairments, and

elevated vulnerability to mood disorders and psychosis. Patterns of tobacco and cannabis co-

use appear to differ by country. An International Tobacco Control Survey identified that
Canada (36.3%), followed by the USA (29.1%), England (21.6%) and Australia (21.4%) had

the highest rates of tobacco and cannabis co-use (Gravely et al., 2020). There are limited

studies examining tobacco and cannabis co-use in the Gambia. The combination of Alcohol,

Cocaine, Tobacco, and Marijuana/Cannabis was reported by one respondent (1.2%). The

simultaneous use of alcohol, cocaine, tobacco, and marijuana/cannabis represents a high-risk

polydrug use pattern associated with increased likelihood of addiction, cardiovascular

complications, and impaired cognitive function. Research indicates that concurrent use of

alcohol and cocaine can lead to the formation of cocaethylene, a toxic metabolite associated

with heightened cardiotoxicity and risk of overdose (GOSSOP et al., 2006). Moreover,

combining tobacco and marijuana/cannabis with alcohol and cocaine can exacerbate

respiratory issues and increase the risk of developing substance use disorders

(AmericanAddictionCenter, 2023). Alcohol, Tobacco, and Marijuana/Cannabis combination

was also reported by one respondent (1.2%). Concurrent use of alcohol, tobacco, and

marijuana/cannabis is common among polydrug users and can result in synergistic effects on

neurocognitive function, motor coordination, and psychosocial well-being as revealed in a

study by Lee (2022). His study also suggests that individuals who engage in this combination

may experience higher levels of subjective intoxication and impaired decision-making

compared to single-substance use. Another dangerous combination of Cocaine, Tobacco,

Marijuana/Cannabis, Kush, and Alcohol was reported by one respondent (1.2%). The

inclusion of cocaine, tobacco, marijuana/cannabis, kush, and alcohol reflects a complex

polydrug use pattern with diverse pharmacological effects and potential for severe health

consequences. Research indicates that polydrug use involving cocaine, marijuana/cannabis,

and alcohol is associated with increased risk of addiction, mental health disorders, and social
dysfunction (Greydanus et al., 2013). Moreover, the addition of kush (a potent strain of

marijuana) alongside alcohol and cocaine may exacerbate respiratory issues and cognitive

impairment (Greydanus et., 2013). Additionally, Kush, Marijuana/Cannabis, and Tobacco

were reported by two respondents (2.4%). The combination of these drugs is characterized

by a high potency and potential for increased risk of addiction, respiratory problems, and

cognitive impairment. The same study by Greydanus et al., (2013) indicates that individuals

who use potent strains of marijuana, such as cannabinoid (locally called kush), may

experience more intense psychoactive effects and higher rates of dependence compared to

individuals using lower potency varieties. Another participant reported using

Marijuana/Cannabis alone. This was reported by one respondent (1.2%). While

marijuana/cannabis use alone, which may seem less risky compared to the combinations

reported by the others. However, it still carries potential health consequences, including

cognitive impairment, respiratory issues, and addiction (Hasin, 2023). Chronic

marijuana/cannabis use has been associated with adverse effects on mental health, cognitive

function, and educational attainment (Hasin, 2023). Marijuana/Cannabis with Alcohol and

Tobacco was reported by one respondent (1.2%). Like other polydrug use, combining

marijuana/cannabis with alcohol and tobacco can lead to intensified psychoactive effects and

increased risk of addiction and respiratory problems (Glavak Tkalić et al., 2013). This

suggests that simultaneous use of these substances may impair cognitive function and

psychomotor performance, leading to impaired decision-making and increased risk-taking

behaviors (Glavak Tkalić et al., 2013). Furthermore, Marijuana/Cannabis with Alcohol,

Tobacco, and Kush was reported by one respondent (1.2%) mentioned using this

combination. The addition of kush (a potent strain of marijuana) alongside alcohol, tobacco,
and marijuana/cannabis suggests a high-risk pattern of polydrug use with potential for severe

health consequences, including addiction, respiratory problems, and cognitive impairment

(Greydanus et al., 2013). Another combination of Marijuana/Cannabis with Kush, reported

by one respondent (1.2%), suggests a pattern of polydrug use characterized by high potency

and potential for increased risk of addiction, respiratory problems, and cognitive impairment

(Hasin, 2023). The participants also reported various other combinations, including Tobacco

with Alcohol (n=1) 1.2%, Tobacco with Alcohol and Kush (n=1) 1.2%, Tobacco with

Alcohol and Marijuana/Cannabis (n=1) 1.2%, Tobacco with Inhalants and

Marijuana/Cannabis with Kush (n=1) 1.2%, Tobacco with Kush and Marijuana/Cannabis (1,

1.2%), Tobacco with Marijuana/Cannabis alone (n=1) 1.2%, Marijuana/Cannabis with Kush

and Tobacco (N=1) 1.2%, Tobacco and Marijuana/Cannabis with Alcohol (n=2) 2.4%, and,

Tobacco and Marijuana/Cannabis with Kush (n=2) 2.4%. While all polydrug use carries

inherent risks, not all combinations are equally dangerous. However, all the combinations

mentioned above increase the potential for harm and requires careful consideration of the

specific substances involved, their interactions, and potential consequences.

Finally, understanding the prevalence and implications of these polydrug combinations is

crucial for developing targeted interventions and harm reduction strategies. Comprehensive

approaches addressing polydrug use should consider the unique characteristics of each

combination and tailor strategies to mitigate associated risks effectively. It would also be

essential to explore the motivations behind specific polydrug combinations and their impact

on individual health outcomes.

5.3 Factors influencing drug abuse

Factors influencing drug abuse among youth in Sukuta encompass a broad spectrum of

interrelated variables, ranging from familial dynamics and peer influences to societal norms

and accessibility.

5.3.1Family Dynamics and drug addiction

Family dynamics emerged as a significant determinant of drug abuse among respondents,

with a notable proportion acknowledging learning to use drugs from home (n=15) 18.1%

agreed; (n=15) 18.1% strongly agreed), indicating potential exposure to parental or sibling

drug use, normalization of substance abuse within the family, or inadequate parental

supervision. This is evident by the substantial portion of respondents that said their parents

are addicted to drugs (n=3) 3.6% agreed; (n=19) 22.9% strongly agreed) and the notable

percentage (21.7%) of respondents agreed (n=5) 6.0% or strongly agreed (n=13), 15.7% that

their siblings are addicted to drugs. Parental and Sibling drug addiction can contribute to a

range of adverse outcomes for children and young adults, including the likelihood of

engaging in drug abuse due to modeling behavior and lack of proper supervision This

suggests that parents and sibling influences can be particularly strong during adolescence,

highlighting the need for targeted interventions addressing familial risk factors for substance

abuse. Compared to other variables, the percentage of respondents agreeing or strongly

agreeing to these notions are relatively low, indicating potential variability in family

backgrounds and drug use patterns. However, they emerged as noteworthy influences,

highlighting the significance of familial relationships in transmitting drug use behaviors

(Alvarez-Alonso et al., 2016). Moreover, the experience of family conflicts (33.7% agreed,

1.2% strongly agreed) and domestic abuse (28.9% agreed, 9.6% strongly agreed) was

associated with drug abuse among respondents, indicating maladaptive coping mechanisms
and psychological distress within the familial context (Alvarez-Alonso et al., 2016).

Conversely, authoritative parenting styles were less prevalent (25.3% agreed, 2.4% strongly

agreed), although associated with lower levels of adolescent substance abuse, underscoring

the protective role of positive parenting practices (Chan et al., 2017). A substantial

proportion (n=21) 25.3% agreed that their parents are not employed, while (20.5%) of

respondents either agreed (n=2) 2.4% or strongly agreed (n=15) 18.1% that their families are

low-income earners. Socioeconomic factors, including parental unemployment and low

income are known risk factors for substance abuse, as individuals from economically

disadvantaged backgrounds may face increased stressors and fewer resources for coping. The

prevalence of low-income families in this sample highlights the need for interventions

addressing socioeconomic disparities in drug abuse prevention efforts.

5.3.2 Peer influence and pressure

Peer influences were also significant, with a notable proportion reporting friends' drug

addiction (n=32) 38.6% agreed and peer influence (n=7) 8.4% agreed, suggesting

susceptibility to peer pressure and social norms surrounding drug use (Collins et al., 1998).

However, the majority disagreed that drug use enhances social status (51.8% disagreed,

48.2% strongly disagreed), challenging conventional beliefs regarding substance use and

social acceptance among youth (Collins et al., 1998).

5.3.3 Societal and cultural factors

Societal and cultural factors played a crucial role, with all the respondents (100%) strongly

disagreeing that their societal culture allows drug use, potentially serving as protective

factors against substance abuse (Russell et al., 2015). Additionally, socioeconomic

disparities, including homelessness (n=24) 28.9% agreed; (n=13) 15.7% strongly agreed that

they do not have a family, and 19, 22.9% agreed; 34, 41.0% strongly agreed that they are

street kids), parental unemployment (n=21) 25.3% agreed and low income (n=2) 2.4%

agreed; (n=215) 18.1% strongly agreed, were identified as influential factors for drug abuse,

Individuals from economically disadvantaged backgrounds may face increased stressors and

fewer resources for coping (Russell et al., 2015). Perceptions of adulthood and associated

behaviors can influence substance use initiation and norms among youth. Therefore, the

rejection of the notion (n=19) 22.9% disagreed and (n=31) 37.3% strongly disagreed) that

substance use defines adulthood by the majority may indicate evolving attitudes towards

substance use and maturity among youth in Sukuta.

5.3.4 Accessibility and affordability

Accessibility and affordability influenced drug abuse patterns, with perceived barriers to drug

access (n=46) 55.4% disagreed that drugs are easy to find potentially limiting substance use

opportunities (Lee, 2022). Additionally, all the participants either disagreed (n=50) 60.2% or

strongly disagreed (n=33) 39.8% that drugs are cheaper at their place. The relatively low

perception of drug availability and affordability suggesting potential barriers to access, which

could be attributed to law enforcement efforts or community factors.

5.3.5 Personal factors

All respondents (100%) reported using drugs for one year or more, which is often associated

with increased risk of addiction, health complications, and social consequences. This

suggests that early intervention is crucial in preventing prolonged drug use and mitigating

associated harms. Only a few respondents agreed (n=22) 26.5% or strongly agreed (n=1)
1.2% that they use drugs daily. Daily drug use is indicative of dependence and addiction,

posing significant risks to physical health, mental well-being, and social functioning (Borders

et al., 2009). This emphasizes the importance of comprehensive treatment approaches,

including pharmacotherapy, counseling, and behavioral interventions, to address chronic

drug use effectively.

Impacts of drugs on daily life

Only about (n=25) 30.1% of respondents agreed that they always have a desire to use drugs.

While 11.6% of respondents agreed (n=9) 10.8% or strongly agreed (n=2) 2.8% that they feel

anxious or stressed when they did not take drugs. Persistent drug cravings are characteristic

of substance dependence and addiction, underscoring the need for comprehensive treatment

and relapse prevention strategies (Borders et al., 2009). About 28.9% of respondents agreed

(n=15) 18.1% or strongly agreed (n=9) 10.8% that they cannot do their daily activities

without drugs. Inability to perform daily activities without drugs indicates significant

impairment in functioning and underscores the debilitating effects of addiction on daily life.

This emphasizes the importance of holistic treatment approaches addressing physical,

psychological, and social aspects of addiction to restore functional capacity and improve

quality of life.

5.3.6 Associated consequences

The study has shown that substance abuse was associated with various adverse

consequences, including familial conflicts (n=31) 37.3% agreed and (n=8) 9.8% strongly

agreed, academic and occupational impairment 57.8% agreed, involvement in criminal

activities 37.3% agreed, and psychiatric hospital admissions 47.0% agreed, highlighting the
 multifaceted impacts of drug abuse on individual and societal well-being (Collins et al.,

1998).

A significant proportion (46.9%) of respondents agreed (n=31) 37.3% or strongly agreed (n=8)

9.8% that drug abuse creates problems between them and their parents. Substance abuse can

strain familial relationships and contribute to interpersonal conflict, emphasizing the need for

family-based interventions and support services. About 20.5% of respondents agreed (n=11),

13.3% or strongly disagreed (n=6) 7.2% that they have been in trouble at work or school because

of drug abuse and a significant proportion (49.4%) of respondents also agreed (n=14) 16.9% or

strongly agreed (n=27) 32.5% that they have lost a job or dropped out of school because of drug

abuse. Substance abuse can impair performance and productivity at work or school, leading to

disciplinary actions, academic failure, and job loss (Hernández-Serrano et al., 2018). This

necessitates early intervention and support services to address substance-related problems in

educational and occupational settings and promote successful reintegration into work and school

environments (Hernández-Serrano et al., 2018). Additionally, a considerable proportion (37.3%)

of respondents agreed (n=3) 3.65% or strongly agreed (n=28) 33.7% that they can do anything to

get a drug. Desperation for obtaining drugs can lead to risky and criminal behaviors,

emphasizing the profound impact of addiction on decision-making and behavior. A significant

proportion (43.3%) of respondents agreed (n=5) 6.0% or strongly agreed (n=31) 37.3% that they

engage in illegal activities to obtain drugs. Involvement in criminal behavior is common among

individuals with substance dependence, underscoring the complex interplay between drug abuse

and criminality. This emphasizes the need for collaborative approaches involving law

enforcement, healthcare providers, and social services to address the intersecting issues of

substance abuse and criminal behavior effectively. A significant proportion (54.2%) of

respondents agreed (n=17) 20.5% or strongly agreed (N=28) 33.7% that they have been engaged

in antisocial behaviors because of drug abuse. Substance abuse is often co-morbid with various

antisocial behaviors, including theft, runaway episodes, and risky sexual activities, which can

further exacerbate social and legal problems. This underscores the importance of comprehensive

interventions addressing substance abuse and associated behavioral problems to reduce

recidivism rates and promote rehabilitation and reintegration into society. A majority (48.1%) of

respondents agreed (n=31) 37.3% or strongly agreed (n=9) 10.8% that they have committed a

crime as a result of drug abuse. Substance abuse is a significant risk factor for involvement in

criminal activities, including drug trafficking, property crimes, and violent offenses, which can

result in legal consequences and incarceration (Tomczyk et al., 2016). This emphasizes the need

for diversionary programs, alternative sentencing options, and rehabilitation services to address

the underlying issues driving substance-related criminal behavior and promote desistance from

crime. A majority (80.7%) of respondents agreed (n=11) 13.3% or strongly agreed (n=5) 6.0%

that they are unable to stop taking drugs when they want to. Loss of control over drug use is a

defining feature of addiction, highlighting the need for comprehensive treatment and support

services to facilitate recovery. This highlights the importance of evidence-based treatments, such

as medication-assisted therapy and cognitive-behavioral therapy, in helping individuals regain

control over their drug use and achieve sustained recovery (Borders et al., 2009).

A significant portion (42.2%) of respondents agreed that they experience withdrawal symptoms

upon discontinuation of drug use. Withdrawal symptoms are physiological and psychological

reactions that occur when drug use is abruptly ceased or reduced. They occur upon

discontinuation of drugs and may involve insomnia, headache, sweating, anxiety, depression,

tremor, agitation, confusion, Hallucinations (American Psychiatric Association, 2013). This

suggests that medically supervised detoxification and withdrawal management protocols are

essential to manage withdrawal symptoms safely and support individuals through the

detoxification process (Tomczyk et al., 2016). A majority (55.4%) of respondents agreed (n=40)

48.2% or strongly agreed (n=6) 7.2% that they are considered delinquent by society.

Stigmatization of individuals with substance abuse disorders as delinquent or morally deficient

can perpetuate social exclusion, discrimination, and barriers to accessing healthcare and support

services. Thus, emphasizing the need for destigmatization efforts, public education campaigns,

and advocacy initiatives to challenge negative stereotypes and promote empathy, understanding,

and support for individuals struggling with addiction. A significant proportion (83.1%) of

respondents disagreed (n=2) 2.4% or strongly disagreed (n=67) 80.7% on having a low income

as a result of drug addiction. Substance abuse can lead to financial instability, unemployment,

and poverty, perpetuating cycles of substance-related harm and socio-economic disadvantage.

This underscores the importance of addressing substance abuse within a broader socio-economic

context, including access to employment opportunities, housing assistance, and social welfare

programs, to mitigate substance-related socio-economic disparities and promote recovery and

social inclusion (Borders et al., 2009). A greater minority (47.0%) of respondents agreed to have

been admitted to a psychiatric hospital. Co-occurring psychiatric disorders are common among

individuals with substance abuse disorders, necessitating integrated treatment approaches that

address both substance abuse and mental health issues. This emphasizes the importance of

screening and assessment for co-occurring disorders, collaborative care models, and evidence-

based treatments, such as dual diagnosis interventions, in promoting optimal outcomes for

individuals with substance abuse and mental health comorbidities.

In conclusion, these variables collectively provide a comprehensive understanding of the

multifaceted factors influencing drug abuse among youth in Sukuta. From family dynamics and

peer influences to societal and cultural norms, each factor plays a unique role in shaping

individual attitudes and behaviors towards substance use. Addressing these factors through

holistic, community-based interventions tailored to the specific needs and contexts of youth in

Sukuta is crucial for preventing and reducing the prevalence of drug abuse in the community.