Knowledge Regarding Drug Abuse among School Students

Objectives: The aim of this study was to assess the level of knowledge regarding drug abuse among the school students. Materials and Methods: A descriptive cross sectional study design was used. 106 samples were selected randomly from grade IX and X of Shree Janak Secondary School. Self-administered structured knowledge questionnaire was used for data collection. Descriptive statistics was used to calculate percentage and frequency. The chi square test was used to find association between selected demographic variable and level of knowledge. P value of 0.05 was considered significant. Results: 99.1% of the respondents heard about drug abuse, 97.9% said drug abuse is bad for health, 96.2% said Gaja is commonly available, 51.9% said high chance of getting HIV with drug abuse, 67% said financial burden as cause, 60.4% said drug abuser performed poorly at school work, 71.7% said awareness program as the way to prevent from drug abuse and 26.4% said counselling. Similarly, 52.8% said rehabilitation is the way to treat drug abuse, 88.7% said dependence to drug as the long term complication of drug abuse. Majority 57.5% had poor, 41.5% have adequate and 0.9% had good level of knowledge regarding drug abuse. Conclusion: Half of the respondents had poor knowledge regarding drug abuse and level of knowledge is significantly higher for Brahmin/Chhetri and poor for Janajati, Dalit and Madhesi. This study supports that knowledge regarding drug abuse is significantly associated with education level, family occupation and family members involved in drug addiction. Research has shown that there is strong relationship between adolescent substance abuse and family drug usage and family peer pressure. 16


Introduction
"Drug abuse" is defined as any use of drugs for non-medical purposes almost always for altering consciousness. Drug abuse denotes substances that change the mental or physical state of a person and that may be used repeatedly for that effect leading to abnormality. 1 "Enjoyment" and "Curiosity" were found to have the major influence in their decision to use a substance. 2 According to Central Bureau of Statistics July 2008 report of Nepal the substances abused in Nepal include cannabis (86.9%), heroin, nitrezepam and buprenorphine (86%), brown sugar (60.5), white sugar (14.3), opium (7.1) and inhalation of adhesives and other polishing substance (2.6%). 3 Substance abuse can be in the form of inhalation, ingestion or intravenous. Altogether there were 46,309 hard drug users of which 92.8% accounted to male and 7.2% accounted to female, the average age at the first time drug intake was 17.7. 3 As the first experience of substance abuse often starts in adolescence, and studies have shown that drug use is mainly related to cigarette and alcohol consumption, evidence shows that nearly three fourth (73.1%) current hard drug users had experience of first time drug intake before they reach 20 years. 3 Majority of the hard drug users have level of education below SLC. 3 The injection mode of drug use is one of the major causes of HIV infection in Nepal. [3][4][5] Academic difficulties (declining grades, absenteeism from school and other activities, and increased potential for dropping out of school), health-related problems (accidental injuries, physical disabilities and diseases, and overdoses), poor peer relationships death due to suicide, homicide, accidents, and illness are problems faced by young drug abusers. 6,7 Both licit and illicit substance use was associated more with male students and the use of a substance by family members had a significant impact on its use by their children. 8 As the young age group spends most of their time in school and peer being a strong determinant or influencing factor all these makes this age group prone to use of licit and illicit substance use. 3,8 The aim of this research was to assess the level of knowledge regarding drug abuses among the students of selected school students and to determine the association between the levels of knowledge regarding drug abuse with selected variables. The findings of the study will be useful to policy maker, researcher, government and non-government agency, guardians, education providers, health providers and leaders to know the education level on drug abuse.

Materials and Methods
A descriptive cross sectional research was conducted in the Shree Janak Secondary School of province 4, Gaidakot Municipality, ward-5of Nawalparasi district. At 10% error and prevalence of 50% 96 samples were required so 106 samples were selected randomly from grade IX (55) and X (51) from each section. 9 Inclusion criteria were students present in the classroom, willing to participate of both genders. Nepali version of questionnaire was used to collect data. Purpose of the study was explained; participation to this study was voluntary and can withdraw any time from the study if they wished. Written consent was obtained from the respondent. Selfadministered questionnaire were distributed to the participant. A pretested semi structured questionnaire was filled by the respondents who were selected for the study. Anonymity and confidentiality of the respondents and data was maintained by giving unique code number to each participant. The duration for the self-administered semi structure questionnaire was 20-30 minutes.
All collected data were reviewed and checked for its completeness, consistency and accuracy. The collected data were organized, coded and entered in excel and transfer to SPSS version 26.The findings was analyzed using descriptive statistics; percentage and frequency. The chi square test was used to find association between selected demographic variable and level of knowledge.
The semi structured questionnaire was developed through intensive literature review, consultation with research guide and subject expert in the related field. Instrument was pretested among 10% of the total sample i.e. students of class IX & X of Tri Juddha Madhyamic Vidhyalaya Birta-4 Birgunj, Parsa. The reliability of the knowledge questionnaire was 0.90.
Self-administered structured knowledge questionnaire was used for data collection. It was divided into two parts. Part I consist of 14 items related to selected socio-demographic variables such as age, sex, ethnicity, religion, economic status, parent's education, parent's occupation, peer pressure, family history relation with parent, teenage curiosity to assess the knowledge regarding drug abuse. Part II consist of 19 structured knowledge questionnaire to assess the knowledge regarding drug abuse to obtain information regarding definition, causes, sign & symptom, effect, prevention, complication and treatment of drug abuse.

Results
57.9% of the respondents had poor knowledge, 41.5% had satisfactory and 0.9% had good knowledge on drug abuse. 99.1% of the respondents heard about drug abuse. Education status of respondent's father was 92.5% and 88.7% for mother. 32.1% of the respondent's father was service holder and 48.1% mother as housewife. 86.8% of the respondent's has family member not involved in drug abuse and 97.2% lived with family. Most of the respondent's (84%) said drug abused person can get out of it and 17% said can't think about other source of entertainment. Majority (60.4%) said drug abused performed poorly at school work. Table 1 represents the socio-demographic characteristics, Table 2 represents knowledge on drug abuse, Table 3 summarizes findings of cause, sign, symptoms and effect of drug abuse, Table 4 summarizes the results of prevention, treatment and complications of drug abuse, Table 5 and 6 represents the level of knowledge regarding drug abuse and association of respondent's level of knowledge with selected variables respectively.

DISCUSSION
Drug abuse affects person's nutrition, sleep, decision making and impulsivity, risk for trauma, violence, injury, and there is risk of communicable diseases to both people who are taking drugs and on those around them. The effect on ability to control their stress level, decision making, ability to learn and remember, etc. make it much more difficult for someone to stop taking the drug even when it's having negative effects on their life and they want to quit. Long term effects include heart or lung disease, cancer, mental illness, HIV/AIDS, hepatitis, and others. 10 Narcotics Drugs (Control) Act, 1976 (2033 BS) is the legal framework for drug control issues in Nepal. The Act has provision for the prevention and treatment of drug users. The Department of Narcotics Control under the Ministry of Home Affairs (MHA) has responsibility for narcotics issues in Nepal. The MHA has established a National Coordination Committee for Drug Abuse Control (NCC) for strengthening of management procedures, policy and strategy. 11 Findings of the present study showed majority (57.9%) of the respondents had poor knowledge regarding drug abuse, 41.5% had satisfactory and 0.9% had good knowledge. A study carried out among high school adolescents of Dhaka by Zaman and Almajidi 12 revealed that among 120 student, 84.2% had poor knowledge about drug abuse, 15.8% had average knowledge and none had good knowledge about it. Whereas, Tsering, Pal and Das Gupta 2 revealed that level of knowledge on harmfulness of substance use was very high (urban 84.6% and rural 61.5%) among high school students in Indian. The study conducted by Haddad L. in Jordanian adolescent showed students of both sexes were knowledgeable about aspects of substance abuse. 13 Billalli SF. finding contradicts with current study and revealed that majority (65%) had inadequate knowledge and (35%) had moderate knowledge regarding drug abuse and its ill effects. 14 Almost 99.1% of the respondents heard about drug abuse. Among them, 41.5% heard from mass media and 12.3% from family. A study carried out by Tsering, Pal and Das Gupta (2010) revealed that media was the most frequent source of information among high school adolescents in India. 2      This study supports that knowledge regarding drug abuse is significantly associated with education level, family occupation and family members involved in drug addiction. Research has shown that there is strong relationship between adolescent substance abuse and family drug usage and family peer pressure. 16 Drug abuse affects individual, family and social life. There is increase in number of adolescents in licit and illicit use of substance. This state of substance abuse needs to be focused on time if not, the state will lose a huge number of productive and creative human resources and there will be state of increase in criminal activities. Adequate knowledge on drug abuse and its effects to adolescent, creating healthy school, social and family environment for children and adolescent is one of key step necessary to prevent this problem. Beside this, since, senior household members are the first and effective educator to their kids, they should be provided with informal education about drug abuse, it's cause, consequences and preventive ways for get rid of drug abuse.

Conclusion
From the result it is concluded that above half of the respondents had poor knowledge regarding drug abuse and level of knowledge is significantly higher for Brahmin/Chhetri and poor for Janajati, Dalit and Madhesi. So, special educational package should be included in the course contents.

Limitation
The study was conducted only in Shree Janak Secondary School of Gaidakot Nawalparasi So the finding cannot be generalized to other setting.

Recommendation
Intervention program like health education, awareness program should be undertaken in order to maintain the knowledge regarding drug abuse at an optimum level. Curriculum regarding drug abuse can be included in their academic schedule. Similar studies can be conducted on a larger scale for wider application. A comparative study can be carried out between government and private secondary school.