Substance abuse refers to the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs. Psychoactive substance use can lead to a cluster of behavioral, cognitive, and physiological phenomena that develops after repeated substance use and it typically includes a strong desire to take the drug, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to drug use than to other activities and obligations, increased tolerance, and sometimes a physical withdrawal state. This cluster of phenomena is called dependence syndrome (1).
The substance related problem occurs in most segments of most societies, resulting in decreased work and school performance, accidents, intoxication while working, absenteeism, violent crime, and theft. Adolescents are reported to be the most vulnerable age group for developing substance abuse problems, with men being at more risk than women (2).
According to the World drug report by United Nations office on Drugs and crimes(UNODC),it is estimated that globally total of 255 million people, or 1 out of 20 people between the ages of 15 and 64 years, used an illicit drug in 2015. This corresponds to a global prevalence of 5.2 percent (range: 3.4-7.0 per cent). The magnitude of the world substance abuse becomes more apparent when considering that about 29.5 million people are suffering from drug related disorders worldwide. 12.19 million Drug users inject drugs, and an estimated 1.65 million of those who inject drugs were living with HIV and 6.1 million of them living with hepatitis C in 2013 (3).
Many factors influence the likelihood of a person becoming a substance abuser or an addict. These factors can be organized into three categories. The first factors are associated with Agent/Drug. Drugs that reliably produce intensely pleasant feelings (euphoria) are more likely to be taken repeatedly. The more strongly reinforcing a drug is, the greater the likelihood that the drug will be abused. The abuse liability of a substance is enhanced by its: - availability /cost, purity/potency, mode of administration, Speed of onset and termination of effects. The second factors are host/User factors, which depends on: genetic predisposition and vulnerability, psychiatric disorders, prior experience or expectation and propensity for risk-taking behavior. Finally the third category is environmental factors including Social setting and community attitude peer influence, paucity of other options for pleasure and diversion (2).
In recent years, Ethiopia has become one of the rapidly developing countries in the world, and this has led to expansion of higher education throughout the country. As a result, millions of young Ethiopians have got the opportunity to learn in these Universities. As these students gather from different areas and social background, there is a great chance of sharing experience including substance use, and these factors made substance abuse to become a common threat in Universities.
According to a study conducted on American high school students, increases in alcohol consumption was shown to result in statistically significant but quantitatively small reductions in GPA for male students and statistically non-significant changes for females (4). On the other hand a study conducted on undergraduate University students in Nigeria revealed that there is a significant relationship between alcohol consumption and academic performance (5). The main reasons indicated in many of above studies are alcohol use related absent-ism, less time spent on studying and lack of concentration in class and exams.
On another study conducted in Hawassa University students in 2015, the lifetime prevalence of Khat chewing was found to be 22.8% (6). Another study conducted in Haromaya University by Tesfaye G. and his colleagues in 2013 showed that 62.4% of the students used at least one substance in their lifetime. This study revealed that the prevalence of khat use was 23.6%. Concerning alcohol drinking habits, the same study revealed that 20% were drinking alcohol. The study also showed that 10.8% of the students were smokers at the time of study. Furthermore, 7.4% of them have used illicit drugs like hashish (7).
Another study was also conducted in the nearby Wolayita Sodo University in 2017. This study indicated that 28.6% of the study participants have used at least one substance with in the 12 months preceding the study. Same study also indicated that Khat use can affect the CGPA of students. On that study, the mean CGPA of chewers (2.56, ± 0.51) was found to be lower than that of non-chewers (2.97, ± 0.50). Those students who smoke cigarettes had lower mean CGPA (2.34, ± 0.41) than non-smokers (2.97, ± 0.50) (8).
The studies conducted in those Universities showed the prevalence of substance abuse to be high. Arba Minch University is not any different. An anecdotal study indicates that substance abuse is a problem in AMU and specifically CMHS students. The prevalence of substance abuse is observed to be high. Around the campus ground there are numbers of places where students can get these substances and this contributes to high substance use among students. Effect of substance use is also reflected in the student’s academic performance.
Many of the above and other researchers conducted in Ethiopian Universities have identified the prevalence and risk factors associated with substance abuse among students. But the focus of many of these researches on examining the effect of drug/substance abuse on academic performance was limited. This study is designed with the objective of assessing the status of substance use among students of Arba Minch University, College of Medicine and health science.