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Nitte University Journal of Health Science

Introduction

The abuse of alcohol and illicit and prescription drugs

continues to be a major health problem internationally.

The United Nations Office on Drugs and Crime (UNODC)

reports that approximately 5 per cent of the world's

population used an illicit drug in 2010 and 27 million

people, or 0.6 per cent of the world's adult population, can

be classified as problem drug users. It is estimated that

heroin, cocaine and other

drugs are responsible for

0.1 to 0.2 million deaths

per year. In addition to

causing death, substance

abuse is also responsible

for significant morbidity

and the treatment of drug

Original Article

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Substance abuse and practices and their consequences among

adolescents and young adults in Mangalore 1 1 1 1 2

Alka Prakash , Vidya B , Wan Nur Suhailah , Anjali Mohanan , Ravi , 3 4

Rashmi Kundapur & Sanjeev Badiger 1 2 3 4 MBBS Students, Medico Social Worker, Professor, Professor, Department of Community Medicine,

K. S. Hegde Medical Academy, Nitte University, Mangalore, Karnataka, India.

Correspondence

Rashmi Kundapur

Professor, Department of Community Medicine, K.S. Hegde Medical Academy,

Nitte University, Mangalore - 575 018, Karnataka, India.

Mobile : +91 98804 96567 E-mail : [email protected]

Abstract

Introduction: Substance abuse is the recent trend among college students. Studies conducted in India shows clear indications of

increasing prevalence of substance abuse among adolescents.

Aims and Objectives: To assess the practice prevalence and consequences of drug abuse among adolescent students.

Materials and Method: This Institution based cross-sectional study conducted in different schools and colleges of Mangalore.

Institutions were randomly picked with pen drop method and 5 institution students were selected as study subjects. Totally 487

students between institutions were selected, the age group of 15-25 years were included in the study. The data was collected by means

of answering a pretested validated questionnaire with anonymity.

Results: According to our study the results showed that 8.60% have tried some substance of abuse such as marijuana (5.51%), LSD

(1.10%), cocaine (1.32%) and others (1.76%). Among the Substance users, 1.54% used it regularly, 1.76% occasionally and 2.20% only

once. 33.03% said it has affected their daily activities and academics 21.05% had picked up a quarrel with friends, family or detained by

police.

Conclusion: Caffeine consumption in the form coffee is quite common amongst the students as a habit. Marijuana is the most popular

drug among the small fraction of students who have tried drugs. Most of them tried it first in college, mainly being influenced by peers.

Keywords: Substance abuse, adolescents, caffeine use

1 addiction creates a tremendous burden on society.

Existing studies have found a high correlation between

adolescent abuse and becoming a problem drug user in 1

adulthood; therefore, it can be inferred that many

problem drug users start abusing drugs at an early age.

Additionally, accidental and intentional fatalities that are

associated with drug and alcohol use represent one of the

leading preventable causes of death for the 15 to 24-year-

old population. Alcohol and other drug use in the

adolescent population carries a high risk for school

underachievement, delinquency teenage pregnancy, and 1

depression. Drug dependence is described as a state,

psychic and sometimes also physical, resulting from the

interaction between a living organism and a drug,

characterize by behavioral n other responses that always

include a compulsion to take a drug on a continuous or

2 periodic basis.

The intention of this study was to estimate the prevalence

of the problem status among the college going young

adults and the knowledge about the de-addiction. The

study was conducted with the objective to study the

practices and consequences of substance abuse among

adolescents and young adults.

Material Methods

The research approach adopted for the study was a simple

descriptive design to assess the practice and consequences

among adolescent with regards to substance abuse. The

substance abuse definition of WHO includes hazardous use

of psychoactive substances, including alcohol and illicit 2

drugs - various drugs including illicit drugs, alcohol,

tobacco, caffeine come under this category. We in this

study have not considered alcohol and tobacco as they

were part of other study. So we included all drugs including

illicit drugs and caffeine use and abuse in our study.

Institution based cross-sectional study conducted in

different colleges of Mangalore. Institutions were

randomly picked with pen drop method and 5 institution

students were selected as study subjects. Taking 20%

practice (by pilot study) as baseline the sample size was

calculated with 80% power of the study and 95%

confidence interval, the sample size was calculated to be

400 with relative precision being 20% (power of study

80%). Considering 20% non-response, we considered to

interview 480 students. Universal sampling method was

for the selection of students. Our total sample was 487. A

questionnaire with questions on the practices and

consequences of drug abuse was prepared. Face validation

and linguistic validation of the questionnaire was done.

Reliability was checked for the questionnaire. The

questionnaire was to be filled anonymously after getting an

informed verbal consent. The students were allowed to

give back the questionnaire empty, or they could half fill it.

The questionnaire was asked to take home get parents

concent and fill it. Institutional ethical clearance was

obtained. Sufficient time was given to the students to

complete the questionnaire. Only students willing to

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participate with consent given were included. The data

obtained were compiled in Microsoft excel and the results

were tabulated.

Results

Among the students included in our study 67.55%

consumed tea, 39.42% consumed coffee, 29.77%

consumed aerated drinks. When we asked about reason

for consuming caffeine 45.58% said because of habit and

12.73% due to stress (table: 1).40.02% of students

intended to reduce consumption of caffeine. But 36.75%

refused to reduce the consumption of caffeine. Proportion

of adolescent students intending to reduce caffeine

consumption was different in different institutions in

Mangalore. (Shown in Fig 2).

Among our subjects 8.41% have tried some substance

of abuse such as marijuana (12.19%),LSD (2.43%),cocaine

(12.19%) and others (48.78% (Fig no: 1). When asked about

the age at which they had first tried, 48.78% said in college (

after 18 years) but 12.19% in secondary schools (09-

12years) (Table no :3). Of the above 7.31% of subjects were

influenced by friends and 9.75% used it to try something

new and 7.31% was due to stress.

Among the users, 21.95% use it regularly. Majority of the

users afford these by means of their pocket money

(56.09%), loans from others (12.19%) and few of them also

resorted to stealing (14.63%).

Among the sample 31.7% said it had affected their daily

activities and academics. 12.19% had picked up a quarrel

with friends, family or detained by police.

The students answered saying 55.44% knowing about

addiction therapy and 11.29% not answering and 33.26%

do not know there is a addiction therapy.

Table : Reason for consuming beverages containing caffeine

among adolescents (n=487)

1

Reasons No. of students Percentage

Stress 62 12.73

Habit 226 45.58

Socializing with peers 39 8

Others 32 6.57

Not answered 135 27.72

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Table : Showing the regularity in substance of abuse

consumption (n= 41)

2 Table : Showing percentage of adolescents practicing substance

of abuse with age of onset (n=41)

3

NUMBER PERCENTAGE

REGULARLY 9 21.95 %

OCCASSIONALLY 8 19.51%

RARELY 7 17.07%

ONLY ONCE 8 1951%

NOT ANSWERED 9 21.95%

NUMBER PERCENTAGE

SECONDARY (9-12 years) 5 12.19%

HIGH SCHOOL (13-15 years) 1 2.43%

PUC (16-17 years) 5 12.19%

COLLEGE ( 18-25 years) 20 48.78%

NOT ANSWERED 10 24.39%

12%

2%

12%

50%

24%

Marijuana LSD Cocaine Others Not answered

Others include - small option like amphetamines, large option of caffeine.

Figure 1 : Showing distribution of prevalence of substance abuse

0.00% 2.00% 4.00% 6.00% 8.00% 10.00% 12.00% 14.00% 16.00% 18.00%

College 1

College 2

College 3

College 4

Figure 2 : showing the proportion of adolescents wanting to

reduce caffeine reduction

Discussion

Caffeine is a bitter substance found in coffee, tea, soft

drinks, cola, nuts, and medicines. It has many effects on the

body's metabolism including stimulating central nervous

system. This can make you more alert and give you boost of

energy. For most people, the amount of caffeine in 2-4 cups

of coffee a day is not harmful. However, too much of

caffeine can cause problems. According to our study

12.58% consume caffeine due to stress, 44.37% as a habit,

7.50% when socializing with peers and other reasons

3.97%. A research done by the University of Puerto Rico on

their students in the year 2013 showed that 54% consumed

caffeine to stay awake , 18% as a part of their routine , other

reasons – 19% , for concentration 12% and as meal

substitutes 8%. The research showed that there was

increase in the consumption of aerated drinks (65.4%) and

coffee (55%) in account of stress. This tells us that in our

study majority of the students consume it as a habit and 3

the association of caffeine consumption and stress is less

whereas in University of Puerto Rico, the association of

caffeine consumption and stress is of great significance.²

Whatever the reason maybe, with repetitive use, physical

dependence or addiction may occur. As caffeine is a

psychoactive drug, it is often regulated. In the United

States, FDA restricts beverages to containing less than

0.02% caffeine; it would be beneficial if such policies were

to be implemented in developing countries as well.

Substance abuse is a patterned use of a substance in which

the user consumes the substance in amounts or with

methods which are harmful to themselves or others. The

exact cause of substance misuse is impossible because

there is not just one direct cause. However substance

abuse and addiction is known to run in families. In the

present study use of substances as well as distribution

among the students were comparable to the finding of

studies of other authors, where we noted both similar and 3,4

dissimilar results with that of other studies .0.8%

adolescents gave the history of their initiation to abuse

substances started during their secondary schooling. Most

of them started during their college time that is about

4.8%.1.10% started from PUC & 0.2% started from high

school. Poor decision-making and impulsive behaviour in

the teenage years can then have lasting effects. Teens that

start abusing alcohol or drugs at an early age are at much

greater risk of developing an addiction later in life

compared to those who misuse drugs later. In our study

5.51% of students were using marijuana, 1.10%were using

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Nitte University Journal of Health Science

LSD, 1.32% were using cocaine &1.76%were using other

substances. Some people are able to use recreational or

prescription drugs without experiencing negative

consequences or addiction. For many others, substance

use can cause problems at work, home, school & in

relationships. Many, try drugs for the first time out of

curiosity, to have good time, because friends are doing it,

an effort to improve athletic performance or ease another

problems like stress, anxiety, depression etc .Use does not

automatically lead to abuse and there is no specific level at

which drug moves from casual to problematic. It varies

with individual. Drug abuse & addiction is less about the

amount of substance consumed or the frequency and more 5

to do with the consequences of drug use . Parents need to

be aware of the increased risk for teens, and the factors

that increase risk. Avoidance of drugs and alcohol at an

early age, and friends who use them, is crucial to not

becoming an addict.

Limitations

This study do not have representative sample from all

colleges and all the questions were self administered so

final truth being unknown.

Conclusion

Caffeine consumption in the form coffee is quite common

amongst the students as a habit. Marijuana is the most

popular drug among the small fraction of students who

have tried drugs. Most of them tried it first in college,

mainly being influenced by peers. The study shows that it

has some affect on their daily activities and academics

mainly because almost all of them have tried it at least once

Acknowledgement

We thank the head of the department, Dr. Uday Kiran

Nalam and all the staff of Community Medicine for their

immense support during the study.

References

1. Boviton, G ; Epstein ,J ; Baker , E ; Diaz, T; and Ifill – Willian, M. School

based drug abuse prevention with inner-city minority youth, Journal

of Child and Adolescent Substance Abuse; 6:5- 19, 1997.

2. WHO (1993). WHO Expert Committee on Drug dependence. Twenty

eighth Report ,No.836 available in www.who.int>right_committee.

3. Josue L Rios, MNSN; Jesmari Betancourt , MHSN:Ideliz Pagan-

Caffeinated –beverage Consumption and its association with Socio-

demographic Characteristics and Stress in First and Second Year

students at the University of Puerto Rico Medical Sciences Campus

(UPR –MSC) ; PRHSJ Vol .32 No.2.June ,2013

4. Dechenla Tsering, Ranabir Pal, and Aparajita Dasgupta. Substance use

among adolescent high school students in India: A survey of

knowledge, attitude, and opinion; Journal of Pharmcy and bioallied

sciences 2010, 2(2): 137– 140

5. Scheier, LL ;Bovtvin , G Diaz, T and Griffin ,K Social skills, competence

and drug refusal efficacy as predictors of adolescent alcohol use

Journal of Drug Education 29(3):251-278,1999.

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